IDSA Recommendations for Preventing and Managing Cryptosporidiosis in HIV-AIDS Preventing Chronic Cryptosporidiosis: • Because chronic cryptosporidiosis occurs primarily in persons with advanced immunodeficiency, initiation of ART before the patient becomes severely immunosuppressed should prevent the disease Preferred Management Strategies: • Initiate or optimize ART for immune restoration to CD4 count >100 cells/mm3 • Aggressive oral and/or IV rehydration and replacement of electrolyte loss, and symptomatic treatment of diarrhea with antimotility agent. • Tincture of opium may be more effective than loperamide as an anti-diarrheal agent Alternative Management Strategies: No therapy has been shown to be effective without ART. Trial of these agents may be used in conjunction with, but not instead of, ART: • Nitazoxanide 500–1000 mg PO BID with food for 14 days (CIII) + optimized ART, symptomatic treatment, and rehydration and electrolyte replacement, or alternatively • Paromomycin 500 mg PO QID for 14 to 21 days (CIII) + optimized ART, symptomatic treatment and rehydration and electrolyte replacement #Cryptosporidiosis #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
