Drugs used in the treatment of pneumocystis carinii pneumonia
TMP-SMX (mild-severe)
TMP: 15-20 mg/kg/day
SMX: 75-100 mg/kg/day
PO or IV divided into 3 or 4 doses per day
Adverse reactions:Rash, fever, neutropenia, hyperkalemia, transaminase elevation
Adjunctive glucocorticoids *
(* Adjunctive glucocorticoids should be given to patients with a room air PA02 /=35 mmHg.)
Prednisone:
40 mg PO twice daily for 5 days
40 mg PO once daily for 5 days
20 mg PO once daily for 11 days
Adverse reactions: Hyperglycemia, hypertension, reactivation of herpetic lesions, ? increased susceptibility to other infections
Pentamidine (moderate-severe)
4 mg/kg/day IV once daily
Adverse reaction: Nephrotoxicity, hyperkalemia, hypoglycemia, hypotension, pancreatitis, dysrhythmias, transaminase elevation
Atovaquone (mild-moderate)
750 mg PO twice daily
Adverse reaction: Rash, fever, transaminase elevation
TMP plus dapsone (mild-moderate)
TMP: 5 mg/kg PO three times daily
Dapsone: 100 mg/day PO once daily
Adverse Reaction; Trimethoprim: Rash, gastrointestinal distress, transaminase elevation, neutropenia
Dapsone: Rash, fever, gastrointestinal upset, methemoglobinemia, hemolytic anemia, (check for G6PD deficiency)
Primaquine plus clindamycin (mild-severe)
Primaquine: 15-30 mg/day PO once daily
Clindamycin: 600 mg IV every 8 hours OR 300-450 mg PO four times daily
Adverse Reactions: Primaquine: Rash, fever, methemoglobinemia, hemolytic anemia (check for G6PD deficiency)
Clindamycin: Rash, diarrhea, Clostridium difficile colitis, abdominal pain
