ID IV: Opportunistic Infections Flashcards
(32 cards)
Criteria for starting PCP prophy
CD4 <200 or AIDS-defining illness
Primary PCP prophy choice
Bactrim QD
Alternative PCP prophy options
Dapsone +/- pyrimethamine/leucovorin
Atovaquone +/- pyrimethamine/leucovorin
Criteria for D/C’ing PCP prophy
CD4 count >200 cells for >3 months on ART
Can consider if CD4 count is 100-200 and viral load has been undectable for ≥3-6 months
Criteria for starting Toxoplasma gondii encephalitis prophy
CD4 <100, toxoplasma IgG positive
Primary Toxoplasma prophy option
Bactrim DS QD
Alternative Toxoplasma prophy options
Dapsone/pyrimethamine/leucovorin
Atovaquone +/- pyrimethamine/leucovorin
Criteria for D/C’ing Toxoplasma prophy
Same as PCP prophy D/C criteria
Can consider if the CD4 count is 100-200 and viral load has been undetectable for ≥3-6 months
Criteria for starting MAC prophy
CD4 <50 and isn’t on ART
Preferred MAC prophy
Azithromycin 1200mg QW
Alternative MAC prophy options
Azithromycin 600mg BIW
Clarithromycin 500mg BID
When to D/C MAC prophy
Starting ART
Preferred treatment for candidiasis
Fluconazole
Alternative treatment for candidiasis: oropharyngeal
itraconazole, posaconazole
Alternative treatment for candidiasis: esophageal
voriconazole, Cresemba, enchinocandin
Secondary prophy treatment for candidiasis
Not recommended
Cryptococcal meningitis preferred treatment
Amphotericin B with flucytosine
Alternate cryptococcal meningitis treatment
Fluconazole with flucytosine
Amphotericin B with fluconazole
Cryptococcal meningitis secondary prophy treatment
Low-dose fluconazole
CMV preferred treatment options
Valganiciclovir, ganiciclovir
Alternate CMV treatment options
foscarnet, cidofovir
CMV secondary prophy treatment
None; just keep the CD4 count >100
MAC preferred treatment options
Clarithromycin or azithromycin + ethambutol
MAC alternate treatment options
Add on a third or fourth agent with rifabuzin, amikacin, streptomycin, moxifloxacin, levofloxacin
