Prophylaxis of Pneumocystosis
| Drug(s) | Dose, Route | Comments |
|---|---|---|
| First-Choice Agent | ||
| TMP-SMX | One tablet (double- or single-strength) qd PO | Incidence of hypersensitivity is high. Rechallenge for non-life-threatening hypersensitivity; consider dose-escalation protocol. |
| Alternative Agents | ||
| Dapsone | 50 mg bid or 100 mg qd PO | Hemolysis is associated with G6PD deficiency. |
Dapsone plus plus | 50 mg qd PO 50 mg weekly PO 25 mg weekly PO | Leucovorin ameliorates cytopenias due to pyrimethamine. |
Dapsone plus Pyrimethamine plus Leucovorin | 200 mg weekly PO 75 mg weekly PO 25 mg weekly PO | Leucovorin ameliorates cytopenias due to pyrimethamine. |
| Pentamidine | 300 mg monthly via Respirgard II nebulizer | Aerosol may cause bronchospasm. Pentamidine is probably less effective than TMP-SMX or dapsone regimens. |
| Atovaquone | 1500 mg qd PO | Requires fatty meal for optimal absorption. |
Abbreviations: TMP-SMX, trimethoprim-sulfamethoxazole.