| Pathogen | Preventive regimens | ||
|---|---|---|---|
| Indication | First choice | Alternatives | |
| I. Recommended for life as standard of care | |||
| Pneumocystis carinii | Prior P. carinii pneumonia | TMP-SMZ, 1 DS orally daily (AI) TMP-SMZ, 1 SS orally daily (AI) | Dapsone, 50 mg orally twice daily or 100 mg orally daily (BI); dapsone, 50 mg orally daily plus pyrimethamine, 50 mg orally every week plus leucovorin, 25 mg orally every week (BI); dapsone, 200 mg orally plus pyrimethamine, 75 mg orally plus leucovorin, 25 mg orally every week (BI); aerosolized pentamidine, 300 mg every month via Respirgard II nebulizer (BI); atovaquone, 1,500 mg orally daily (BI); TMP-SMZ, 1 DS orally three times weekly (CI) |
| Toxoplasma gondii* | Prior toxoplasmic encephalitis | Sulfadiazine, 500 to 1,000 mg orally four times daily plus pyrimethamine, 25 to 75 mg orally daily plus leucovorin, 10 to 25 mg orally daily (AI) | Clindamycin, 300 to 450 mg orally every 6 to 8 hours plus pyrimethamine, 25 to 75 mg orally daily plus leucovorin, 10 to 25 mg orally daily (BI); atovaquone, 750 mg orally every 6 to 12 hours with or without pyrimethamine, 25 mg orally daily plus leucovorin, 10 mg orally daily (CIII) |
| Mycobacterium avium complex† | Documented disseminated disease | Clarithromycin, 500 mg orally twice daily (AI) plus ethambutol, 15 mg per kg orally daily (AII); with or without rifabutin, 300 mg orally daily (CI) | Azithromycin, 500 mg orally daily (AII) plus ethambutol, 15 mg per kg orally daily (AII); with or without rifabutin, 300 mg orally daily (CI) |
| Cytomegalovirus | Prior end-organ disease | Ganciclovir, 5 to 6 mg per kg IV 5 to 7 days per week or 1,000 mg orally three times daily (AI); or foscarnet, 90 to 120 mg per kg IV daily (AI); or (for retinitis) ganciclovir sustained-release implant every 6 to 9 months plus ganciclovir, 1.0 to 1.5 g orally three times daily (AI) | Cidofovir, 5 mg per kg IV every other week with probenecid, 2 g orally 3 hours before the dose followed by 1 g orally 2 hours after the dose and 1 g orally 8 hours after the dose (total of 4 g) (AI). Fomivirsen, 1 vial (330 μg) injected into the vitreous and repeated every 2 to 4 weeks (AI) |
| Crypotococcus neoformans | Documented disease | Fluconazole, 200 mg orally daily (AI) | Amphotericin B, 0.6 to 1.0 mg per kg IV weekly to three times weekly (AI); itraconazole, 200 mg orally daily (BI) |
| Histoplasma capsulatum | Documented disease | Itraconazole capsule, 200 mg orally twice daily (AI) | Amphotericin B, 1.0 mg per kg IV weekly (AI) |
| Coccidioides immitis | Documented disease | Fluconazole, 400 mg orally daily (AII) | Amphotericin B, 1.0 mg per kg IV weekly (AI); itraconazole, 200 mg orally twice daily (AII) |
| Salmonella species (non-typhi)§ | Bacteremia | Ciprofloxacin, 500 mg orally twice daily for several months (BII) | Antibiotic chemoprophylaxis with another active agent (CIII) |
| II. Recommended only if subsequent episodes are frequent or severe | |||
| Herpes simplex virus | Frequent/severe recurrences | Acyclovir, 200 mg orally three times daily or 400 mg orally twice daily (AI) Famciclovir, 500 mg orally twice daily (AI) | Valacyclovir, 500 mg orally twice daily (CIII) |
| Candida (oropharyngeal or vaginal) | Frequent/severe recurrences | Fluconazole, 100 to 200 mg orally daily (CI) | Itraconazole solution, 200 mg orally daily (CI); ketoconazole, 200 mg orally daily (CIII) |
| Candida (esophageal) | Frequent/severe recurrences | Fluconazole, 100 to 200 mg orally daily (BI) | Itraconazole solution, 200 mg orally daily (BI); ketoconazole, 200 mg orally daily (CIII) |