Template:Toxoplasmosis Antibiotics: Difference between revisions
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*[[Pyrimethamine]] (25 mg/day orally) and sulfadiazine (4 g/day orally) divided 2 or 4 times daily until delivery AND | *[[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 | **[[Leucovorin]] 10-25 mg/day orally to prevent bone marrow suppression | ||
*{{AntibioticDose|drug=Dapsone|dose=50mg PO QD; Off label use|context=Toxoplasmosis prophylaxis|disease=Toxoplasmosis|population=Adult}} | |||
====Congenital/Pediatric==== | |||
*{{AntibioticDose|disease=Toxoplasmosis|drug=Pyrimethamine|dose=2mg/kg/day PO x 2 days then 1mg/kg/day x 2-6 months, then 1mg/kg MWF|context=Congenital/Pediatric|population=Pediatric}} AND | |||
**{{AntibioticDose|disease=Toxoplasmosis|drug=Sulfadiazine|dose=50mg/kg PO BID|context=Congenital/Pediatric|population=Pediatric}} AND | |||
**{{AntibioticDose|disease=Toxoplasmosis|drug=Leucovorin|dose=10mg PO 3x/week|context=Congenital/Pediatric adjunct|population=Pediatric}} | |||
*Duration: 12 months for congenital toxoplasmosis | |||
*Alternative: {{AntibioticDose|disease=Toxoplasmosis|drug=Trimethoprim-Sulfamethoxazole DS|display=TMP/SMX|dose=5mg/kg (TMP) PO/IV q12hrs|context=Pediatric Immunosuppressed alt|population=Pediatric}} | |||
*{{AntibioticDose|disease=Toxoplasmosis|drug=Clindamycin|dose=20-30mg/kg/day PO/IV divided q6hrs (max 2.4g/day)|context=Pediatric Sulfa Allergy alt|population=Pediatric}} if sulfa allergic | |||
*{{AntibioticDose|disease=Toxoplasmosis|drug=Spiramycin|dose=50-100mg/kg/day PO divided q8hrs|context=Pediatric/Congenital alt|population=Pediatric}} | |||
Latest revision as of 13:13, 20 March 2026
Immunocompetent
Antibiotics only needed if patient has severe symptoms
- Pyrimethamine 200mg PO load then 50mg PO q24hrs x 4 weeks AND
- Leucovorin 10mg PO q24hrs AND
- Sulfadiazine 1g PO q6hrs
Immunosprepressed
- Pyrimethamine 200mg PO load then 75mg PO q24hrs x 4-8 weeks AND Leucovorin 25mg PO q24hrs PLUS
- Sulfadiazine 1500mg PO q6hrs OR
- Clindamycin 600mg PO or IV q6hrs OR
- Azithromycin 1200mg PO q24hrs OR
- Atovaquone 1500mg PO q12hrs
OR
- TMP/SMX 5mg/kg IV q12hrs
Pregnant
- Spiramycin 1g PO q8hrs[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
- Dapsone 50mg PO QD; Off label use
Congenital/Pediatric
- Pyrimethamine 2mg/kg/day PO x 2 days then 1mg/kg/day x 2-6 months, then 1mg/kg MWF AND
- Sulfadiazine 50mg/kg PO BID AND
- Leucovorin 10mg PO 3x/week
- Duration: 12 months for congenital toxoplasmosis
- Alternative: TMP/SMX 5mg/kg (TMP) PO/IV q12hrs
- Clindamycin 20-30mg/kg/day PO/IV divided q6hrs (max 2.4g/day) if sulfa allergic
- Spiramycin 50-100mg/kg/day PO divided q8hrs
- ↑ Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.