Infection

Drug

Adult dosage

Pediatric dosage

Malaria, Prevention of, continued⁸⁴

All Plasmodium species in chloroquine-resistant areas⁶³,⁶⁴,⁶⁵

Drug of choice:⁶⁷

Atovaquone/proguanil⁶⁸

1 adult tab/d⁸⁸

• 5–8kg: 1/2 peds tab/d⁶⁸,⁸⁸

• 9–10kg: 3/4 peds tab/d⁶⁸,⁸⁸

• 11–20kg: 1 peds tab/d⁶⁸,⁸⁸

• 21–30kg: 2 peds tabs/d⁶⁸,⁸⁸

• 31–40kg: 3 peds tabs/d⁶⁸,⁸⁸

• >40kg: 1 adult tab/d⁶⁸,⁸⁸

OR

Doxycycline⁷,²¹,⁷¹

100 mg PO daily⁸⁹

2 mg/kg/d PO, up to 100 mg/d⁸⁹

OR

Mefloquine⁷⁴,⁷⁵,⁹⁰

250 mg PO once/wk⁹¹

• 5–10kg: 1/8 tab once/wk⁹¹

• 11–20kg: 1/4 tab once/wk⁹¹

• 21–30kg: 1/2 tab once/wk⁹¹

• 31–45kg: 3/4 tab once/wk⁹¹

• >45kg: 1 tab once/wk⁹¹

Alternative:⁹²

Primaquine⁷,⁷⁹ phosphate

30 mg base PO daily⁹³

0.6 mg/kg base PO daily⁹³

Malaria, Prevention of relapses: P. vivax and P. ovale⁶⁷

Drug of choice:

Primaquine phosphate⁷⁹

30 mg base/d PO X 14d

0.6 mg base/kg/d PO X 14d

Malaria, Self-Presumptive Treatment⁹⁴

Drug of Choice:

Atovaquone/proguanil⁷,⁶⁸

4 adult tabs once/d X 3d⁶⁹

• < 5kg: not indicated

• 5–8kg: 2 peds tabs once/d X 3d

• 9–10kg: 3 peds tabs once/d X 3d

• 11–20kg: 1 adult tab once/d X 3d

• 21–30kg: 2 adult tabs once/d X 3d

• 31-40kg: 3 adult tabs once/d X 3d

• >40kg: 4 adult tabs once/d X 3d⁶⁹

OR

Quinine sulfate

650 mg PO q8h X 3 or 7d⁷⁰

30 mg/kg/d PO in 3 doses X 3 or 7d⁷⁰

plus

doxycycline⁷,²¹,⁷¹

100 mg PO bid X 7d

4 mg/kg/d PO in 2 doses X 7d

OR

Artesunate^76*

4 mg/kg/d PO X 3d

4 mg/kg/d PO X 3d

plus see footnote ⁷⁸

MICROSPORIDIOSIS

Ocular (Encephalitozoon hellem, E.cuniculi, Vittaforma corneae [Nosema corneum])

Drug of choice:

Albendazole⁷,¹²

400 mg PO bid

plus fumagillin^95*

Intestinal(E. bieneusi, E. [Septata] intestinalis)

E. bieneusi

Drug of choice:

Fumagillin^96*

20 mg PO tid X 14d

E. intestinalis

Drug of choice:

Albendazole⁷,¹²

400 mg PO bid X 21d

Disseminated (E. hellem, E. cuniculi, E. intestinalis, Pleistophora sp., Trachipleistophora sp. and Brachiola vesicularum)

Drug of choice:⁹⁷

Albendazole⁷,^12*

400 mg PO bid

Mites, see SCABIES

MONILIFORMIS moniliformis infection

Drug of choice:

Pyrantel pamoate⁷,^13*

11 mg/kg PO once, repeat twice, 2wks apart

11 mg/kg PO once, repeat twice, 2wks apart

Naegleria species, see AMEBIC MENINGOENCEPHALITIS, PRIMARY

Necator americanus, see HOOKWORM infection

OESOPHAGOSTOMUM bifurcum

Drug of choice:

see footnote ⁹⁸

Onchocerca volvulus, see FILARIASIS

Opisthorchis viverrini, see FLUKE infection

Paragonimus westermani, see FLUKE infection

Pediculus capitis, humanus, Phthirus pubis, see LICE

Pinworm, see ENTEROBIUS

PNEUMOCYSTIS JIROVECI (formerly carinii) pneumonia (PCP)⁹⁹

Drug of choice:

Trimethoprim/sulfamethoxazole

TMP 15 mg/SMX 75 mg/kg/d, PO or IV in 3 or 4 doses X 21d

TMP 15 mg/SMX 75 mg/kg/d, PO or IV in 3 or 4 doses X 21d

Alternative:

Primaquine⁷,⁷⁹

30 mg base PO daily X 21d

0.3 mg/kg base PO daily X 21d

plus clindamycin^7,18

600 mg IV q6h X 21d, or 300–450 mg PO q6h X 21d

15–25 mg/kg IV q6h X 21d, or 10 mg/kg PO q6h X 21d

OR

Trimethoprim⁷

5 mg/kg PO tid X 21d

5 mg/kg PO tid X 21d

plus dapsone⁷

100 mg daily X 21d

2 mg/kg/d PO X 21d

OR

Pentamidine

3–4 mg/kg IV daily X 21d

3–4 mg/kg IV daily X 21d

OR

Atovaquone

750 mg PO bid X 21d

• 1–3 mos: 30 mg/kg/d PO X 21d

• 4–24 mos: 45 mg/kg/d PO X 21d

• >24 mos: 30 mg/d PO X 21d

Primary and secondary prophylaxis¹⁰⁰

Drug of Choice:

Trimethoprim/sulfamethoxazole

1 tab (single or double strength) daily or 1 DS tab PO 3d/wk

TMP 150 mg/SMX 750 mg/m2/d PO in 2 doses 3d/wk

Alternative:

Dapsone⁷

50 mg PO bid or 100 mg PO daily

• 2 mg/kg/d (max. 100 mg) PO or

• 4 mg/kg (max. 200 mg) PO each wk

OR

Dapsone⁷

50 mg PO daily or 200 mg PO each wk

plus pyrimethamine¹⁰¹

50 mg PO or 75 mg PO each wk

OR

Pentamidine

300 mg aerosol inhaled monthly via Respirgard II nebulizer

≥5yrs: 300 mg inhaled monthly via Respirgard II nebulizer

OR

Atovaquone^7,20

1500 mg PO daily

• 1–3 mos: 30 mg/kg/d PO

• 4–24 mos: 45 mg/kg/d PO

• >24 mos: 30 mg/kg/d PO

River Blindness, see FILARIASIS

Roundworm, see ASCARIASIS

Sappinia diploidea, see AMEBIC MENINGOENCEPHALITIS, PRIMARY

SCABIES (Sarcoptes scabiei)

Drug of choice:

5% Permethrin

Topically once¹⁰²

Topically once¹⁰²

Alternative:¹⁰³

Ivermectin⁷,¹⁶,¹⁰⁴

200 mcg/kg PO once¹⁰²

200 mcg/kg PO once¹⁰²

10% Crotamiton

Topically once/d X 2

Topically once/d PO X 2

SCHISTOSOMIASIS (Bilharziasis)

S. haematobium

Drug of choice:

Praziquantel³⁹

40 mg/kg/d PO in 2 doses X 1d

40 mg/kg/d PO in 2 doses X 1d

S. japonicum

Drug of choice:

Praziquantel³⁹

60 mg/kg/d PO in 3 doses X 1d

60 mg/kg/d PO in 3 doses X 1d

S. mansoni

Drug of choice:

Praziquantel³⁹

40 mg/kg/d PO in 2 doses X 1d

40 mg/kg/d PO in 2 doses X 1d

Alternative:

Oxamniquine^105*

15 mg/kg PO once¹⁰⁶

20 mg/kg/d PO in 2 doses X 1d¹⁰⁶

S. mekongi

Drug of choice:

Praziquantel³⁹

60 mg/kg/d PO in 3 doses X 1d

60 mg/kg/d PO in 3 doses X 1d

Sleeping sickness, see TRYPANOSOMIASIS

STRONGYLOIDIASIS (Strongyloides stercoralis)

Drug of choice:¹⁰⁷

Ivermectin¹⁶

200 mcg/kg/d PO X 2d

200 mcg/kg/d PO X 2d

Alternative:

Albendazole⁷,¹²

400 mg PO bid X 7d

400 mg PO bid X 7d

TAPEWORM infection

-Adult (intestinal stage)

Diphyllobothrium latum (fish), Taenia saginata (beef), Taenia solium (pork), Dipylidium caninum (dog)

Drug of choice:

Praziquantel^7,39

5–10 mg/kg PO once

5–10 mg/kg PO once

Alternative:

Niclosamide^108*

2 g PO once

50 mg/kg PO once

Hymenolepis nana (dwarf tapeworm)

Drug of choice:

Praziquantel^7,39

25 mg/kg PO once

25 mg/kg PO once

Alternative:

Nitazoxanide⁵,⁷

500 mg PO once/d or bid X 3d¹⁰⁹

• 1–3yrs: 100 mg PO bid X 3d¹⁰⁹

• 4–11yrs: 200 mg PO bid X 3d¹⁰⁹

-Larval (tissue stage)

Echinococcus granulosus (hydatid cyst)

Drug of choice:¹¹⁰

Albendazole¹²

400 mg PO bid X 1–6mos

15 mg/kg/d (max. 800 mg) X 1–6mos

Echinococcus multilocularis

Treatment of choice:

see footnote ¹¹¹

Taenia solium (Cysticercosis)

Treatment of choice:

see footnote ¹¹²

Alternative:

Albendazole¹²

400 mg PO bid X 8–30d; can be repeated as necessary

15 mg/kg/d (max. 800 mg) PO in 2 doses X 8–30d; can be repeated as necessary

OR

Praziquantel^7,39

100 mg/kg/d PO in 3 doses X 1 day then 50 mg/kg/d in 3 doses X 29 days

100 mg/kg/d PO in 3 doses X 1 day then 50 mg/kg/d in 3 doses X 29 days

Toxocariasis, see VISCERAL LARVA MIGRANS

TOXOPLASMOSIS (Toxoplasma gondii)

Drug of choice:¹¹³

Pyrimethamine¹¹⁴

25-100 mg/d PO X 3–4wks

2 mg/kg/d PO X 2d, then 1 mg/kg/d (max. 25 mg/d) X 4wks¹¹⁵

plus sulfadiazine¹¹⁶

1–1.5 g PO qid X 3-4wks

100-200 mg/kg/d PO X 3-4wks

TRICHINELLOSIS (Trichinella spiralis)

Drug of choice:

Steroids for severe symptoms

plus

Albendazole⁷,¹²

400 mg PO bid X 8–14d

400 mg PO bid X 8–14d

Alternative:

Mebendazole⁷

200–400 mg PO tid X 3d, then 400–500 mg tid X 10d

200–400 mg PO tid X 3d, then 400–500 mg tid X 10d

TRICHOMONIASIS (Trichomonas vaginalis)

Drug of choice:¹¹⁷

Metronidazole

2 g PO once or 500 mg bid X 7d

15 mg/kg/d PO in 3 doses X 7d

OR

Tinidazole⁶

2 g PO once

50 mg/kg once (max. 2 g)

TRICHOSTRONGYLUS infection

Drug of choice:

Pyrantel pamoate⁷,^13*

11 mg/kg base PO once (max. 1 g)

11 mg/kg PO once (max. 1 g)

Alternative:

Mebendazole⁷

100 mg PO bid X 3d

100 mg PO bid X 3d

OR

Albendazole⁷,¹²

400 mg PO once

400 mg PO once

TRICHURIASIS (Trichuris trichiura, whipworm)

Drug of choice:

Mebendazole

100 mg PO bid X 3d or 500 mg once

100 mg PO bid X 3d or 500 mg once

Alternative:

Albendazole⁷,¹²

400 mg PO X 3d

400 mg PO X 3d

OR

Ivermectin⁷,¹⁶

200 mcg/kg PO daily X 3d

200 mcg/kg/d PO X 3d

TRYPANOSOMIASIS¹¹⁸

T. cruzi (American trypanosomiasis, Chagas’ disease)

Drug of choice:

Nifurtimox^*

8-10 mg/kg/d PO in 3–4 doses X 90–120d

• 1-10yrs: 15–20 mg/kg/d PO in 4 doses X 90–120d

• 11-16yrs: 12.5–15 mg/kg/d in 4 doses X 90–120d

OR

Benznidazole^119*

5-7 mg/kg/d PO in 2 doses X 30–90d

• < 12yrs: 10 mg/kg/d PO in 2 doses X 30–90d

• >12 yrs: 5–7 mg/kg/d in 2 doses X 30–90d

T. brucei gambiense (West African trypanosomiasis, sleeping sickness)

hemolymphatic stage

Drug of choice:¹²⁰

Pentamidine⁷

4 mg/kg/d IM X 7d

4 mg/kg/d IM X 7d

Alternative:

Suramin^*

100-200 mg (test dose) IV, then 1g IV on days 1,3,7,14 and 21

20 mg/kg on d 1,3,7,14 and 21