TREATMENT OF PNEUMOCYSTIS PNEUMONIA INFECTION TREATMENT FURTHER ...
INFECTION
SEVERITY
TREATMENT OF PNEUMOCYSTIS PNEUMONIA
TREATMENT 1ST LINE
2ND LINE
FURTHER INFORMATION
PROPHYLAXIS
LICENCE/ AVAILABILITY
PNEUMOCYSTIS PNEUMONIA (PCP)
(Pneumocystis jiroveci)
Mild to Moderate
PaO2 >9.3kpa on
room air
Co-trimoxazole oral 1920mg TDS
or
90mg/kg/day in 3 divided doses (rounded to nearest 480mg)
Duration: 21 days
Option1: Clindamycin oral 600mg tds + Primaquine* oral 30mg OD
Option2: Dapsone 100mg oral daily + Trimethoprim oral 20mg/kg/day in 3 divided doses rounded to nearest 50mg
*Check G6PD prior to prescribing dapsone or primaquine but do not delay treatment.
For prophylaxis for HIV patients click here
For all other patients refer to patient speciality and reason for immunosuppression or seek advice from ID/Microbiology.
Primaquine is not licensed in the UK but can be prescribed on a named patient basis ? contact pharmacist to order.
Atovaquone is only available as a liquid.
Option3: Atovaquone liquid oral 750mg BD, with food (preferably high fat)
Atovaquone has poor bioavailability. Presence of food (particularly high fat) increases the absorption 2-3 fold.
Duration: 21 days
Severe
Co-trimoxazole IV**
Option1:
*Check G6PD prior to prescribing dapsone or
infusion 120mg/kg/day for Clindamycin IV infusion primaquine but do not delay treatment.
PaO2 9.3kpa on
3 days then reduce to IV/PO 90mg/kg/day for 18 days. The total daily dose
600 QDS or 900mg TDS + Primaquine* oral
If O2 saturations ................
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