OI

Question 1

Active PCP treatment

Answer 1

If O2 is over 70, mild:
Bactrim PO 2 DS or 15 mg/kg PO

If O2 is under 70, mod-severe:
IV Bactrim 15-20 mg/kg/day q6-8h

Question 2

Primary prophylaxis for PCP - criteria and tx

Answer 2

CD4 less than 200 or has AIDS

Bactrim 1 DS tab daily

Continue til CD4 is over 200 for 3 months on HAART

Question 3

Secondary prophylaxis for PCP - criteria and tx

Answer 3

Had it before

One DS or SS PO QD

Question 4

Active toxoplasmosis treatment

Answer 4

Pyrimethamine 200 mg once
then
If over 60 kg, use 75  mg daily
If under 60 kg, use 50 mg daily
Duration is 6 weeks or longer

Question 5

Toxoplasmosis primary prophylaxis

Answer 5

IgG pos with CD4 under 100

Bactrim DS po daily

Question 6

Toxoplasmosis secondary prophylaxis

Answer 6

Pyrimethamine 25-50 mg 
PLUS
Sulfadiazine 2-4 g (2-4 divided doses)
PLUS
Leucovorin 10-25 mg PO daily

Question 7

MAC active treatment

Answer 7

Clarithromycin 500 mg BID
PLUS
Ethambutol 15 mg/kg QD

Question 8

MAC primary prophylaxis

Answer 8

When CD4 is less than 50
Azithromycin 1200 mg once weekly
or
Azithromycin 600 mg twice weekly
D/c when CD4 is over 100 for 3 mos

Question 9

MAC secondary prophylaxis

Answer 9

Lifelong treatment with the azithromycin 600 mg twice weekly

Duration:
At least 12 months
Have to have no signs/sx
Over 6 mos with CD4 over 100

Question 10

Cryptococcus active tx

Answer 10

Liposomal amphotericin B 3-4 mg/kg daily
PLUS
Flucytosine 25 mg/kg QID

THEN

8 weeks fluconazole 400 mg QD

THEN

Fluconazole 200 mg QD for 1 year

Stop as long as CD4 is over 100 for 3 months, they completed the full tx plus one year maintenance, and they’re asymptomatic