Template:Toxoplasmosis Antibiotics: Difference between revisions
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====Immunocompetent==== | ====Immunocompetent==== | ||
''Antibiotics only needed if patient has severe symptoms'' | ''Antibiotics only needed if patient has severe symptoms'' | ||
*[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 50mg PO | *[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 50mg PO q24hrs x4wks AND | ||
**[[Leucovorin]] 10mg PO q24hrs AND | **[[Leucovorin]] 10mg PO q24hrs AND | ||
**[[Sulfadiazine]] 1g PO q6hrs | **[[Sulfadiazine]] 1g PO q6hrs | ||
====Immunosprepressed==== | ====Immunosprepressed==== | ||
*[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 75mg PO q24hrs x4-8wks AND [[Leucovorin]] 25mg PO q24hrs PLUS | |||
*[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 75mg PO | |||
**[[Sulfadiazine]] 1500mg PO q6hrs OR | **[[Sulfadiazine]] 1500mg PO q6hrs OR | ||
**[[Clindamycin]] 600mg PO or IV q6hrs OR | **[[Clindamycin]] 600mg PO or IV q6hrs OR | ||
**[[Azithromycin]] 12000mg PO q24hrs OR | **[[Azithromycin]] 12000mg PO q24hrs OR | ||
**[[Atovaquone]] 1500mg PO q12hrs | **[[Atovaquone]] 1500mg PO q12hrs | ||
OR | |||
*[[TMP/SMX]] 5mg/kg IV q12hrs | |||
====Pregnant==== | |||
*[[Spiramycin]] 1 g orally every 8 hours<ref>Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.</ref> | |||
**If amniotic fluid is positive treat with 3 weeks of pyrimethamine (50 mg/day orally) + sulfadiazine (3 g/day orally in 2-3 divided doses) | |||
**Alternate with a 3-week course of Spiramycin 1 g 3 times daily OR | |||
*[[Pyrimethamine]] (25 mg/day orally) and sulfadiazine (4 g/day orally) divided 2 or 4 times daily until delivery AND | |||
**[[Leucovorin]] 10-25 mg/day orally to prevent bone marrow suppression | |||
Latest revision as of 00:23, 31 December 2025
Immunocompetent
Antibiotics only needed if patient has severe symptoms
- Pyrimethamine 200mg PO one dose (for loading) THEN 50mg PO q24hrs x4wks AND
- Leucovorin 10mg PO q24hrs AND
- Sulfadiazine 1g PO q6hrs
Immunosprepressed
- Pyrimethamine 200mg PO one dose (for loading) THEN 75mg PO q24hrs x4-8wks AND Leucovorin 25mg PO q24hrs PLUS
- Sulfadiazine 1500mg PO q6hrs OR
- Clindamycin 600mg PO or IV q6hrs OR
- Azithromycin 12000mg PO q24hrs OR
- Atovaquone 1500mg PO q12hrs
OR
- TMP/SMX 5mg/kg IV q12hrs
Pregnant
- Spiramycin 1 g orally every 8 hours[1]
- If amniotic fluid is positive treat with 3 weeks of pyrimethamine (50 mg/day orally) + sulfadiazine (3 g/day orally in 2-3 divided doses)
- Alternate with a 3-week course of Spiramycin 1 g 3 times daily OR
- Pyrimethamine (25 mg/day orally) and sulfadiazine (4 g/day orally) divided 2 or 4 times daily until delivery AND
- Leucovorin 10-25 mg/day orally to prevent bone marrow suppression
- ↑ Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.