Infection

Drug

Adult dosage

Pediatric dosage

Hydatid cyst, see TAPEWORM infection

Hymenolepis nana, see TAPEWORM infection

ISOSPORIASIS (Isospora belli)

Drug of choice:⁴⁸

Trimethoprim-sulfamethoxazole⁷

TMP 160 mg/SMX 800 mg (1 DS tab) PO bid X 10d

TMP 10 mg/kg/d/SMX 50 mg/kg/d PO in 2 doses X 10d

LEISHMANIA

Visceral⁴⁹,⁵⁰

Drug of choice:

Liposomal amphotericin B⁵¹

3 mg/kg/d IV d 1–5, 14 and 21⁵²

3 mg/kg/d IV d 1–5, 14 and 21⁵²

OR

Sodium stibogluconate^*

20 mg Sb/kg/d IV or IM X 28d

20 mg Sb/kg/d IV or IM X 28d

OR

Miltefosine^53*

2.5 mg/kg/d PO (max 150 mg/d) X 28d

2.5 mg/kg/d PO (max 150 mg/d) X 28d

Alternative:

Meglumine antimonate^*

20 mg Sb/kg/d IV or IM X 28d

20 mg Sb/kg/d IV or IM X 28d

OR

Amphotericin B⁷

1 mg/kg IV daily x 15–20d or every second day for up to 8 wks

1 mg/kg IV daily X 15–20d or every second day for up to 8 wks

OR

Paromomycin⁷,¹³,^54*

15 mg/kg/d IM X 21d

15 mg/kd/d IM X 21d

Cutaneous⁴⁹,⁵⁵

Drugs of choice:

Sodium stibogluconate^*

20 mg Sb/kg/d IV or IM X 20d

20 mg Sb/kg/d IV or IM X 20d

OR

Meglumine antimonate^*

20 mg Sb/kg/d IV or IM X 20d

20 mg Sb/kg/d IV or IM X 20d

OR

Miltefosine^53*

2.5 mg/kg/d PO (max 150 mg/d) X 28d

2.5 mg/kg/d PO (max 150 mg/d) X 28d

Alternative:⁵⁶

Paromomycin⁷,¹³,^54*

Topically 2x/d X 10-20d

Topically 2x/d X 10-20d

OR

Pentamidine⁷

2-3 mg/kg IV or IM daily or every second day X 4–7 doses⁵⁷

2–3 mg/kg IV or IM daily or every second day X 4–7 doses⁵⁷

Mucosal⁴⁹,⁵⁸

Drug of choice:

Sodium stibogluconate^*

20 mg Sb/kg/d IV or IM X 28d

20 mg Sb/kg/d IV or IM X 28d

OR

Meglumine antimonate^*

20 mg Sb/kg/d IV or IM X 28d

20 mg Sb/kg/d IV or IM X 28d

OR

Amphotericin B⁷

0.5–1 mg/kg IV daily or every second day for up to 8wks

0.5–1 mg/kg IV daily or every second day for up to 8wks

OR

Miltefosine^53*

2.5 mg/kg/d PO (max 150 mg/d) X 28d

2.5 mg/kg/d PO (max 150 mg/d) X 28d

LICE infestation (Pediculus humanus, P. capitis, Phthirus pubis)⁵⁹

Drug of choice:

0.5% Malathion⁶⁰

Topically

Topically

OR

1% Permethrin⁶¹

Topically

Topically

Alternative:

Pyrethrins with piperony^l butoxide⁶⁰

Topically

Topically

OR

Ivermectin⁷,¹⁶,⁶²

200 mcg/kg PO

>15kg: 200 mcg/kg PO

Loa loa, see FILARIASIS

MALARIA, Treatment of (Plasmodium falciparum,⁶³P. vivax,⁶⁴P. ovale, and P. malariae⁶⁵)

ORAL⁶⁶

P. falciparum or unidentified species acquired in areas of chloroquine-resistant P. falciparum⁶³

Drug of choice:⁶⁷

Atovaquone/proguanil⁶⁸

• 2 adult tabs bid⁶⁹ or

• 4 adult tabs once/d X 3d

• < 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 3d

OR

Quinine sulfate

650 mg q8h X 3 or 7d⁷⁰

30 mg/kg/d in 3 doses X 3 or 7d⁷⁰

plus

doxycycline⁷,²¹,⁷¹

100 mg bid X 7d

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

or plus

tetracycline⁷,²¹

250 mg qid X 7d

25 mg/kg/d in 4 doses X 7d

or plus

clindamycin⁷,¹⁸,⁷²

20 mg/kg/d in 3 doses X 7d⁷³

20 mg/kg/d in 3 doses X 7d

Alternative:⁶⁷

Mefloquine⁷⁴,⁷⁵

750 mg followed 12 hrs later by 500 mg

15 mg/kg followed 12 hrs later by 10 mg/kg

OR

Artemether/lumefantrine⁷⁶,^77*

6 doses over 3d (4 tabs/dose at 0, 8, 24, 36, 48 and 60 hours)

• 6 doses over 3d at same intervals as adults; < 15kg: 1 tab/dose

• 15–25kg: 2 tabs/dose

• 25–35kg: 3 tabs/dose

• >35kg: 4 tabs/dose

OR

Artesunate^76*

plus see footnote ⁷⁸

4 mg/kg/d X 3d

4 mg/kg/d X 3d

P. vivax acquired in areas of chloroquine-resistant P. vivax⁶⁴

Drug of choice:⁶⁷

Mefloquine⁷⁴

750 mg PO followed 12 hrs later by 500 mg

15 mg/kg PO followed 12 hrs later by 10 mg/kg

OR

Atovaquone/proguanil⁶⁸

2 adult tabs bid⁶⁹ or 4 adult tabs once/d X 3d

• < 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 3d

either followed by

primaquine phosphate⁷⁹

30 mg base/d PO X 14d

0.6 mg/kg/d PO X 14d

Alternative:^{67 79}

Chloroquine phosphate⁸⁰

25 mg base/kg PO in 3 doses over 48 hrs⁸¹

25 mg base/kg PO in 3 doses over 48 hrs⁸¹

OR

Quinine sulfate

650 mg PO q8h X 3-7d⁷⁰

30 mg/kg/d PO in 3 doses X 3-7d⁷⁰

plus

doxycycline⁷,²¹,⁷¹

100 mg PO bid X 7d

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

either followed by

primaquine

30 mg base/d PO X 14d

0.6 mg/kg/d PO X 14d phosphate⁷⁹

All Plasmodium species except chloroquine-resistant P. falciparum⁶³ and chloroquine-resistant P. vivax⁶⁴

Drug of choice:^{67 79}

Chloroquine phosphate⁸⁰

1 g (600 mg base) PO, then 500 mg(300 mg base) 6 hrs later, then 500mg (300 mg base) at 24 and 48 hrs⁸¹

10 mg base/kg (max. 600 mg base) PO, then 5 mg base/kg 6 hrs later, then 5 mg base/kg at 24 and 48 hrs⁸¹

PARENTERAL⁶⁶

All Plasmodium species (Chloroquine-sensitive and resistant)

Drug of choice:^{67 79},⁸²

Quinidine gluconate⁸³

10 mg/kg IV loading dose (max. 600 mg) in normal saline over 1–2 hrs, followed by continuous infusion of 0.02 mg/kg/min until PO therapy can be started

10 mg/kg lV loading dose (max. 600 mg) in normal saline over 1–2 hrs, followed by continuous infusion of 0.02 mg/kg/min until PO therapy can be started

OR

Quinine dihydrochloride^83*

20 mg/kg IV loading dose in 5% dextrose over 4 hrs, followed by 10 mg/kg over 2–4 hrs q8h (max. 1800 mg/d) until PO therapy can be started

20 mg/kg IV loading dose in 5% dextrose over 4 hrs, followed by 10 mg/kg over 2–4 hrs q8h (max. 1800 mg/d) until PO therapy can be started

OR

• Artesunate^76*

• plus see footnote ⁷⁸

2.4 mg/kg/dose IV X 3d at 0, 12, 24, and 48 hrs

2.4 mg/kg/dose IV X 3d at 0, 12, 24, and 48 hrs

Malaria, Prevention of⁸⁴

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

Drug of choice:⁶⁷,^79,85

Chloroquine phosphate⁸⁰,⁸⁶

500 mg (300 mg base) PO once/wk⁸⁷

5 mg/kg base PO once/wk, up to adult dose of 300 mg base⁸⁷