Template:PCP pneumonia antibiotics: Difference between revisions

(Created page with "====Mild Disease==== *TMP/SMX 2 DS tablets PO q8hrs daily OR *Dapsone 100mg PO once daily + TMP 5mg/kg PO q8hrs OR **''caution: dapsone an cause methemoglobinemia'...")
 
(Add pediatric treatment and prophylaxis dosing)
 
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====Mild Disease====
====Mild Disease====
*[[TMP/SMX]] 2 DS tablets PO q8hrs daily OR
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Trimethoprim-Sulfamethoxazole DS|dose=2 DS tablets PO q8hrs|context=Mild disease|display=TMP/SMX|population=Adult}} OR
*[[Dapsone]] 100mg PO once daily + [[TMP]] 5mg/kg PO q8hrs OR
**High incidence of allergy in HIV
**''caution: dapsone an cause methemoglobinemia''
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Dapsone|dose=100mg PO once daily|context=Mild disease with TMP|population=Adult}} + [[Trimethoprim-Sulfamethoxazole DS|TMP]] 5mg/kg PO q8hrs OR
**''caution: dapsone can cause methemoglobinemia''
*[[Atavaquone]] 750mg PO q12hrs  OR
*[[Atavaquone]] 750mg PO q12hrs  OR
*[[Primaquine]] 30mg PO q24hrs + [[Clindamycin]] 450mg PO q8hrs
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Primaquine|dose=30mg PO q24hrs|context=Mild disease with Clindamycin|population=Adult}} + {{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Clindamycin|dose=450mg PO q8hrs|context=Mild disease with Primaquine|population=Adult}}


====Severe Disease====
====Severe Disease====
*[[TMP/SMX]] 5mg/kg IV q8hrs daily x 21 days OR
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Trimethoprim-Sulfamethoxazole DS|dose=5mg/kg IV q8hrs x 21 days|context=Severe disease|display=TMP/SMX|population=Adult}} OR
*[[Pentamidine]] 4mg/kg IV daily infused over 60 minutes OR
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Pentamidine|dose=4mg/kg IV daily over 60 min|context=Severe disease|population=Adult}} OR
*[[Primaquine]] 30mg PO once daily + [[Clindamycin]] 900mg IV q8hrs daily
**Watch for side effects of hypoglycemia and hypotension
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Primaquine|dose=30mg PO once daily|context=Severe disease with Clindamycin|population=Adult}} + {{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Clindamycin|dose=900mg IV q8hrs|context=Severe disease with Primaquine|population=Adult}}


====Prophylaxis====
====Prophylaxis====
*[[TMP/SMX]] 1 double strength tablet daily, but one single strength tablet daily or one double-strength three times weekly is acceptable.
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Trimethoprim-Sulfamethoxazole DS|dose=1 DS tablet daily|context=Prophylaxis|display=TMP/SMX|population=Adult}}, but one single strength tablet daily or one double-strength three times weekly is acceptable.<ref>CDC Guidelines for Prophylaxis Against Pneumocystis carinii Pneumonia for Children Infected with Human Immunodeficiency Virus http://www.cdc.gov/mmwr/preview/mmwrhtml/00001957.htm</ref>
 
====Pediatric Treatment====
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Trimethoprim-Sulfamethoxazole DS|display=TMP/SMX|dose=5mg/kg (TMP) IV/PO q6-8hrs x 21 days|context=Pediatric Treatment|population=Pediatric}}
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Pentamidine|dose=4mg/kg IV daily x 21 days|context=Pediatric Severe, TMP/SMX intolerant|population=Pediatric}} if TMP/SMX intolerant
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Dapsone|dose=2mg/kg/day PO (max 100mg)|context=Pediatric Mild|population=Pediatric}} + TMP 15mg/kg/day PO divided TID for mild disease
 
====Pediatric Prophylaxis====
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Trimethoprim-Sulfamethoxazole DS|display=TMP/SMX|dose=5mg/kg/day (TMP) PO divided BID 3 days/week|context=Pediatric Prophylaxis|population=Pediatric}} (first line)
*{{AntibioticDose|disease=Pneumocystis jirovecii pneumonia|drug=Dapsone|dose=2mg/kg/day PO daily (max 100mg)|context=Pediatric Prophylaxis alt|population=Pediatric}} or [[Atovaquone]] as alternatives

Latest revision as of 13:14, 20 March 2026

Mild Disease

  • TMP/SMX 2 DS tablets PO q8hrs OR
    • High incidence of allergy in HIV
  • Dapsone 100mg PO once daily + TMP 5mg/kg PO q8hrs OR
    • caution: dapsone can cause methemoglobinemia
  • Atavaquone 750mg PO q12hrs OR
  • Primaquine 30mg PO q24hrs + Clindamycin 450mg PO q8hrs

Severe Disease

Prophylaxis

  • TMP/SMX 1 DS tablet daily, but one single strength tablet daily or one double-strength three times weekly is acceptable.[1]

Pediatric Treatment

  • TMP/SMX 5mg/kg (TMP) IV/PO q6-8hrs x 21 days
  • Pentamidine 4mg/kg IV daily x 21 days if TMP/SMX intolerant
  • Dapsone 2mg/kg/day PO (max 100mg) + TMP 15mg/kg/day PO divided TID for mild disease

Pediatric Prophylaxis

  • TMP/SMX 5mg/kg/day (TMP) PO divided BID 3 days/week (first line)
  • Dapsone 2mg/kg/day PO daily (max 100mg) or Atovaquone as alternatives
  1. ↑ CDC Guidelines for Prophylaxis Against Pneumocystis carinii Pneumonia for Children Infected with Human Immunodeficiency Virus http://www.cdc.gov/mmwr/preview/mmwrhtml/00001957.htm
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