Prophylaxis of Pneumocystosis | ||
| DRUG(S) | DOSE, ROUTE | COMMENTS |
|---|---|---|
| First-choice agent | ||
| TMP-SMX | 1 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: G6PD, glucose-6-phosphate dehydrogenase; TMP-SMX, trimethoprim-sulfamethoxazole.