toxoplasmosis cerebri
Advices
| Priority | Medication | Remarks | 
|---|---|---|
| Priority: 1st choice | Medication: sulfadiazine po 1500mg 4dd 6 weeks + pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks + folinezuur po 15mg 1dd 6 weeks | |
| Priority: 1st choice alternative | Medication: cotrimoxazol (trimethoprim +sulfamethoxazol) iv or po 5/25mg/kg 2dd 6 weeks | |
| Priority: 2nd choice | Medication: clindamycine iv 600mg 4dd 6 weeks + pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks + folinezuur po 15mg 1dd 6 weeks | 
                          Remarks: 
                           SWAB remarks clindamycine iv of po | 
| Priority: 3rd choice | Medication: atovaquon po 1500mg 2dd 6 weeks + pyrimethamine po loading dose 200mg, 75mg 1dd 6 weeks + folinezuur po 15mg 1dd 6 weeks | 
                          Remarks: 
                           SWAB remarks suspensie, innemen met voedsel | 
Sources
- 
          
                          https://richtlijnhiv.nvhb.nl/index.php/Profylaxe_en_behandeling_van_opportunistische_infecties
              
              
            
            
                          Richtlijnen Ned. Ver. van HIV behandelaars 
- 
          
                          NVP therapierichtlijn 2020_30.pdf
              
              
            
            
                          Therapierichtlijn Parasitaire infecties 2020, Nederlandse Vereniging voor Parasitologie 
- 
          
                          clinicalinfo.hiv.gov
              
              
            
            
                          DHHS Guidelines (NIH) 
Antimicrobial resources
The following antimicrobial agents have been used in these recommendations:
External antimicrobial resources
Menu position
Metadata
            Swab vid: G-8313.5
            Updated: 05/20/2025 - 13:52
            Status: Published
          
 
          
General comments
NB! Gewicht < 60 kg: dosering sulfadiazine po 1000 mg 4dd, dosering pyrimethamine po 50 mg 1 dd (oplaaddosis 200 mg)
Behandelduur 6 weken. Na behandeling secundaire profylaxe.
Primaire profylaxe indien CD4+cellen <100cellen/µl; cotrimoxazol po 480mg 1dd blijkt in de praktijk effectief.
Ernstige symptomatische toxoplasmose bij immuuncompetente gastheer: bovenstaand regime gedurende 2—4 weken.
Na behandeling secundaire profylaxe.