Template:Toxoplasmosis Antibiotics: Difference between revisions

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====Immunosprepressed====
====Immunosprepressed====
*[[TMP/SMX]] 5mg/kg IV q12hrs OR
*[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 75mg PO q24hrs x4-8wks AND [[Leucovorin]] 25mg PO q24hrs PLUS
*[[Pyrimethamine]] 200mg PO one dose (for loading) THEN 75mg PO q24hrs x4-8wks AND [[Leucovorin]] 25mg PO q24hrs PLUS
**[[Sulfadiazine]] 1500mg PO q6hrs OR
**[[Sulfadiazine]] 1500mg PO q6hrs OR
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**[[Azithromycin]] 12000mg PO q24hrs OR
**[[Azithromycin]] 12000mg PO q24hrs OR
**[[Atovaquone]] 1500mg PO q12hrs
**[[Atovaquone]] 1500mg PO q12hrs
OR
*[[TMP/SMX]] 5mg/kg IV q12hrs


====Pregnant====
====Pregnant====
*Spiramycin 1 g orally every 8 hours<ref>Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.</ref>
*[[Spiramycin]] 1 g orally every 8 hours<ref>Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.</ref>
**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)
**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
**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
*[[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

Latest revision as of 00:23, 31 December 2025

Immunocompetent

Antibiotics only needed if patient has severe symptoms

Immunosprepressed

OR

Pregnant

  • Spiramycin 1 g orally every 8 hours[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
  1. Paquet C, Yudin MH. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. Jan 2013;35(1):78-9.