Treatment and prophylaxis of cryptoccocosis and toxoplasmosis in HIV infection
| First choice | Alternative | |||
| Cryptoccocosis: | ||||
| Acute infection | Amphotericine B, 0.7 mg/kg/day iv and flucytosine, 100 mg/kg/day orally or iv in 4 divided doses for 2 weeks, then fluconazole, 400 mg orally/day for 8 weeks | Fluconazole, 400 mg orally/day for 10 weeks, or | ||
| Fluconazole 200–400 mg orally/day for 10 weeks and flucytosine 150 mg/kg/day orally or iv in 4 divided doses for 2 weeks | ||||
| Suppressive therapy | Fluconazole 200 mg orally/day | Amphotericine B, 0.6–1.0 mg/kg iv/week, or | ||
| Itraconazole, 200 mg orally/day | ||||
| Toxoplasmosis: | ||||
| Acute infection | Pyrimethamine 100–200 mg loading dose (2 days), then 50–100 mg orally/day plus folinic acid 10 mg orally/day+ sulfadiazine 4–8 g orally/day for at least 6 weeks | Pyrimethamine plus folinic acid plus clindamycin 900–1200 mg iv/6h or 300–450 mg orally/6h for at least 6 weeks, or | ||
| Trimethoprim 160 mg plus sulfamethoxazole 800 mg/8h orally or iv for at least 6 weeks | ||||
| Suppressive therapy | Pyrimethamine 25–75 mg orally/day plus folinic acid 10 mg orally/day+sulfadiazine 500–1000 mg orally/6 h | Pyrimethamine plus folinic acid plus clindamycin 300–450 mg orally/6h, or | ||
| Trimethoprim, 160 mg plus sulfamethoxazole, 800 mg orally/day | ||||
| Prophylaxis (patients with positive IgG serology and CD4 count <100/mm3) | Trimethoprim 160 mg plus sulfamethoxazole 800 mg orally /day | Dapsone 50 mg/day plus pyrimethamine 50 mg/week plus folinic acid 25 mg/week | ||