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Template:Toxoplasmosis Antibiotics
From WikEM
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
- TMP/SMX 5mg/kg IV q12hrs OR
- 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
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
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