HIV: OI Treatment Flashcards
PCP
1st: TMP-SMX + steroids if PaO2 35
2nd: clinda + primaquine +/- steroids
Duration: 21 days
Toxoplasmosis
1st: pyrimethamine + sulfadiazine + leucovorin
2nd: pyrimethamine + clinda OR TMP-SMX OR atovaquone + pyrimethamine OR atovaquone + sulfadiazine
Duration: at least 6 weeks then chronic maintenance therapy
Cryptosporidiosis
1st: nothing clearly effective without ART but can also add nitazoxanide OR paromomycin
Duration: 14-21 days
Microsporidiosis
1st: it’s complicated but could consider nitazoxanide or albendazole
TB
1st: 2mo RIPE, 4mo RI
Duration: 6mo for pulmonary (extend to 9mo if cx positive at 2mo); 9-12 for extrapulmonary (unless just bone/joint then 6-9mo)
MAC (disseminated)
1st: ethambutol + (clarithro or azithro) +/- third drug such as rifabutin, amikacin, or moxifloxacin
Duration: at least 12mo
Bartonella
1st: doxy (add gent if endocarditis
2nd: erythromycin, azithro, or clarithromycin
Mucocutaneous candidiasis
1st: thrush –> fluconzole 100mg daily or topical with clotrimazole troches; esophageal –> fluconazole 100mg daily; vulvo-vaginal –> fluconazole 150mg once (longer if severe or recurrent)
Cryptococcus
1st: ampho B + 5-FC at least 2wks then fluconazole (can do just fluconazole if mild and localized)
Histoplasmosis
1st: ampho B at least 2wks then itraconazole (can do just itra if mild and localized)
Coccidioidomycosis
1st: ampho B then fluconazole (can do just fluc if mild and localized)
Aspergillosis
1st: vori
2nd: ampho B
CMV
1st: (val)ganciclovir, route of administration (PO, IV, intra-ocular) depends on location and severity
2nd: foscarnet
HSV
1st: valacyclovir 1g q12 or acyclovir 400mg q8
2nd; foscarnet if resistance
VZV
1st: (val)acyclovir
