Which medications are used in the treatment of toxoplasmosis in patients with AIDS?

Updated: Mar 08, 2019
  • Author: Murat Hökelek, MD, PhD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Patients with AIDS are treated with pyrimethamine 200 mg orally initially, followed by 50-75 mg/day orally plus folinic acid 10 mg/day orally plus sulfadiazine 4-8 g/day orally for as long as 6 weeks, followed by lifelong suppressive therapy or until immune reconstitution.

Suppressive therapy for patients with AIDS (CD4 count < 100 cells/μL) is pyrimethamine 50mg/day orally plus sulfadiazine 1-1.5 g/day orally plus folinic acid 10 mg/day orally for life or until immune reconstitution.

Patients with AIDS, CNS toxoplasmosis, and evidence of midline shift or increased intracranial pressure may also benefit from steroid therapy.

Diagnosing toxoplasmosis in the absence of definitive tissue or culture evidence may be perilous because serology may be misleading and a false-positive IgM result is somewhat common. Consequently, empiric therapy should be avoided.


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