Toxoplasmosis - ernstig/cerebri (Toxoplasma gondii)
Advices
| Priority | Medication | Remarks |
|---|---|---|
|
Priority: 1st choice |
Medication: sulfadiazine po 1500mg 4dd 6 weeks +
pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks +
folinezuur po 15mg 1dd 6 weeks |
|
|
Priority: 1st choice alternative |
Medication: cotrimoxazol (trimethoprim +sulfamethoxazol) iv or po 5/25mg/kg 2dd 6 weeks |
|
|
Priority: 2nd choice |
Medication: clindamycine iv 600mg 4dd 6 weeks +
pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks +
folinezuur po 15mg 1dd 6 weeks |
Remarks:
clindamycine iv of po |
|
Priority: 3rd choice |
Medication: atovaquon po 1500mg 2dd 6 weeks +
pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks +
folinezuur po 15mg 1dd 6 weeks |
Remarks:
suspensie, innemen met voedsel |
Sources
-
https://richtlijnhiv.nvhb.nl/index.php/Profylaxe_en_behandeling_van_opportunistische_infecties
Richtlijnen Nederlandse Vereniging van HIV behandelaars
-
NVP therapierichtlijn 2020_30.pdf
Therapierichtlijn Parasitaire infecties 2020, Nederlandse Vereniging voor Parasitologie
-
https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/toxoplasmosis
DHHS Guidelines for the Prevention and Treatment of Opportunistic Infections in Hiv-Infected Adults and Adolescents: Toxoplasmosis
Antimicrobial resources
The following antimicrobial agents have been used in these recommendations:
External antimicrobial resources
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Metadata
Swab vid: G-500239.2
Updated: 01/30/2025 - 16:42
Status: Published
General comments
NB! Gewicht < 60 kg: dosering sulfadiazine po 1000 mg 4dd, dosering pyrimethamine po 50 mg 1 dd (oplaaddosis 200 mg)
Behandelduur 6 weken. Na behandeling secundaire profylaxe.
Primaire profylaxe indien CD4+cellen <100cellen/µl; cotrimoxazol po 480mg 1dd blijkt in de praktijk effectief.
Ernstige symptomatische toxoplasmose bij immuuncompetente gastheer: bovenstaand regime gedurende 2—4 weken.