IDSA Recommendations for Treating Isospora belli Infection in HIV-AIDS Treating Isospora belli Infection General Management Considerations: • Fluid and electrolyte support in patients with dehydration • Nutritional supplementation for malnourished patients Preferred Therapy for Acute Infection: • TMP-SMX (160 mg/800 mg) PO (or IV) QID for 10 days or • TMP-SMX (160 mg/800 mg) PO (or IV) BID for 7–10 days • One approach is to start with TMP-SMX (160 mg/800 mg) BID regimen first, and increase daily dose and/or duration (up to 3–4 weeks) if symptoms worsen or persist • IV therapy for patients with potential or documented malabsorption Alternative Therapy For Acute Infection (For Patients with Sulfa Intolerance): • Pyrimethamine 50–75 mg PO daily + leucovorin 10–25 mg PO daily or • Ciprofloxacin 500 mg PO BID for 7 days Chronic Maintenance Therapy (Secondary Prophylaxis) (In Patients with CD4 Count <200/mm3) Preferred Therapy: • TMP-SMX (160 mg/800 mg) PO 3 times weekly (AI) Alternative Therapy: • TMP-SMX (160 mg/800 mg) PO daily or • TMP-SMX (320 mg/1600 mg) PO 3 times weekly or • Pyrimethamine 25 mg PO daily + leucovorin 5–10 mg PO daily • Ciprofloxacin 500 mg PO 3 times weekly (CI) as a second line alternative Criteria for Discontinuation of Chronic Maintenance Therapy: • Sustained increase in CD4 count >200 cells/mm3 for >6 months in response to ART and without evidence of active I. belli infection #IsosporaBelli #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
