Page 946 - Basic _ Clinical Pharmacology ( PDFDrive )

932 SECTION VIII Chemotherapeutic Drugs

TABLE 52–7 Treatment of other protozoal infections. Not all preparations are available in the USA. 1

Organism or
Clinical Setting Drugs of Choice 2 Alternative Drugs
Babesia species Clindamycin, 600 mg 3 times daily for 7 days Atovaquone or azithromycin
plus
Quinine, 650 mg for 7 days
Balantidium coli Tetracycline, 500 mg 4 times daily for 10 days Metronidazole, 750 mg 3 times daily for 5 days
Cryptosporidium species Paromomycin, 500–750 mg 3 or 4 times daily for 10 days Azithromycin, 500 mg daily for 21 days
Cyclospora cayetanensis Trimethoprim-sulfamethoxazole, one double-strength tablet 4 times
daily for 7–14 days
Dientamoeba fragilis Iodoquinol, 650 mg 3 times daily for 20 days Tetracycline, 500 mg 4 times daily for 10 days
or
Paromomycin, 500 mg 3 times daily for 7 days
Giardia lamblia Metronidazole, 250 mg 3 times daily or 500 mg twice daily for 5 days Furazolidone, 100 mg 4 times daily for 7 days
or or
Tinidazole, 2 g once Albendazole, 400 mg daily for 5 days
Isospora belli Trimethoprim-sulfamethoxazole, one double-strength tablet 4 times Pyrimethamine, 75 mg daily for 14 days
daily for 10 days, then twice daily for 21 days
plus
Folinic acid, 10 mg daily for 14 days
Microsporidia Albendazole, 400 mg twice daily for 20–30 days
Leishmaniasis 3
Visceral (L donovani, Sodium stibogluconate, 20 mg/kg/d IV or IM for 28 days Meglumine antimoniate
L chagasi, L infan-
tum) or mucosal or or
(L braziliensis) Amphotericin (liposomal preparations preferred (3 mg/kg/d IV on Pentamidine, 2–4 mg/kg IM daily or every
days 1–5, 14, and 21)); various other dosing regimens, including other day for up to 15 doses
single dose
or
or Combinations of listed drugs
Miltefosine, 2.5 mg/kg/d for 28 days
or
Paromomycin,15 mg/kg for 21 days
Cutaneous (L major, Sodium stibogluconate, 20 mg/kg/d IV or IM for 20 days Meglumine antimoniate
L tropica, L mexicana,
L braziliensis) or
Miltefosine
or
Topical or intralesional therapies
Pneumocystis jiroveci, Trimethoprim-sulfamethoxazole, 15–20 mg trimethoprim Pentamidine
P carinii 4 component/kg/d IV, or two double-strength tablets every 8 hours
for 21 days or
Trimethoprim-dapsone
or
Clindamycin plus primaquine
or
Atovaquone
Toxoplasma gondii
Acute, congenital, Pyrimethamine plus clindamycin plus folinic acid Pyrimethamine plus sulfadiazine plus
immunocompromised folinic acid
Pregnancy Spiramycin, 3 g daily until delivery
(Continued)