Treatment of Pneumocystosisa | ||
| DRUG(S) | DOSE, ROUTE | ADVERSE EFFECTS |
|---|---|---|
| First-choice agent | ||
| TMP-SMX | TMP (5 mg/kg) plus SMX (25 mg/kg) q6-8h PO or IV (i.e., 2 double-strength tablets tid or qid) | Fever, rash, cytopenias, hepatitis, hyperkalemia |
| Alternative agents | ||
| Atovaquone | 750 mg bid PO | Rash, fever, hepatitis |
plus | 300-450 mg q6h PO or 600 mg q6-8h IV 15-30 mg qd PO | Hemolysis (G6PD deficiency), methemoglobinemia, neutropenia, rash |
| Pentamidine | 3-4 mg/kg qd IV | Hypotension, azotemia, cardiac arrhythmias (torsades des pointes), pancreatitis, dysglycemias, hypocalcemia, neutropenia, hepatitis |
| Adjunctive agent | ||
| Prednisone or methylprednisolone | 40 mg bid × 5 d, 40 mg qd × 5 d, 20 mg qd × 11 d; PO or IV | Peptic ulcer disease, hyperglycemia, mood alteration, hypertension |
a Treatment can be administered for 14 days to non-HIV-infected pts with mild disease and for 21 days to all other pts.
Abbreviations: G6PD, glucose-6-phosphate dehydrogenase; TMP-SMX, trimethoprim-sulfamethoxazole.