| Drugs |
Dosing |
Remarks |
| 1) TMP/SMX |
15-20 mg/kg of TMP
IV in 4 divided doses for 21 days |
Drug of choice Shift to oral administration as soon as clinical improvement occurs |
| 2) Pentamidine |
4 mg/kg/day OD IV for 21 days or shift to
oral Atovaquone after 7-10 days of IV therapy |
Alternative drug if child intolerant to TMP-SMX or no clinical improvement after 5-7 days of TMP-SMX. |
| 3) Atovaquone |
30-40 mg/kg/day PO in BD doses for 21 days (max 750 mg/dose. For children between 3-24 months dose of 45 mg/kg/day |
- Limited data in children
- Alternative therapy |
| 4) Primaquine/ Clindamycin |
Primaquine base 0.3 mg/kg OD PO (max 30 mg/day)
+
Clindamycin 10 mg/kg IV or PO every 6 hours (max: 600 mg IV, 300-450 mg PO) for 21 days |
- Alternative therapy
- Data in children not available |
| 5) Dapsone/ Trimethoprim |
Dapsone – 2 mg/kg/day OD PO
+
Trimethoprim 15 mg/kg/day in 3 divided doses PO for 21 days |
>- Limited data in children - Alternative therapy |
| 6) Steroids |
Prednisolone
Day 1-5 – 2 mg/kg/
day PO BD
Day 6-10 – 1 mg/kg/day PO
Day 11-12 – 0.5 mg/kg/day PO
OR
IV Methyl Prednisolone
Day 1-7 – 1 mg/kg/every 6 hours
Day 8 & 9 – 1 mg/kg every 12 hours Day 10 & 11 – 0.5 mg/kg every 12 hours
Day 12-16 – 1 mg/kg every 24 hours |
Indications
- PaO 2 <70 mm of Hg at room air |
