Recommendations
| Dosage | Remarks | |
|---|---|---|
|
1st choice
|
sulfadiazine oral 1500 mg 4 times daily 6 weeks
+ pyrimethamine oral loading dose 200 mg, 75 mg once daily 6 weeks+ folinic acid oral 15 mg once daily 6 weeks |
|
|
1st choice alternative
|
co-trimoxazole (trimethoprim + sulfamethoxazole) IV or oral 5/25 mg/kg twice daily 6 weeks
|
|
|
2nd choice
|
clindamycin IV 600 mg 4 times daily 6 weeks
+ pyrimethamine oral loading dose 200 mg, 75 mg once daily 6 weeks+ folinic acid oral 15 mg once daily 6 weeks |
SWAB remarks clindamycin IV or oral |
|
3rd choice
|
atovaquone oral 1500 mg twice daily 6 weeks
+ pyrimethamine oral loading dose 200 mg, 75 mg once daily 6 weeks+ folinic acid oral 15 mg once daily 6 weeks |
SWAB remarks suspension, take with food |
NB! Weight < 60 kg: sulfadiazine oral dose 1000 mg 4 times daily, pyrimethamine oral dose 50 mg once daily (loading dose 200 mg)
Treatment duration 6 weeks. After treatment, secondary prophylaxis.
Primary prophylaxis if CD4+ cells <100 cells/µl; co-trimoxazole oral 480 mg once daily appears effective in practice.
Severe symptomatic toxoplasmosis in an immunocompetent host: the above regimen for 2–4 weeks.