Table 2 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 acid folinic 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 acid folinic 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