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Home Therapy Infections in HIV / cellular immune disorders

Cystoisosporidiosis (Cystoisospora belli)

Advices

≥ 18 years
Priority Medication Remarks
Priority:
 1st choice 		Medication:

cotrimoxazol (trimethoprim +sulfamethoxazol) po 960mg 2dd 7 days
Remarks:

Bij blijvende verstoorde afweer (bv. bij HIV en CD4+ cellen <100*10E6/L) na behandeling secundaire profylaxe, zie onder.
Priority:
 2nd choice 		Medication:

ciprofloxacine po 500mg 2dd 7 days
Remarks:

Bij blijvende verstoorde afweer (bv. bij HIV en CD4+ cellen <100*10E6/L) na behandeling secundaire profylaxe, zie onder.
Priority:
 2nd choice alternative 		Medication:

pyrimethamine po 50/75mg 1dd

folinezuur po 10/25mg 1dd

Remarks:

Bij blijvende verstoorde afweer (bv. bij HIV en CD4+ cellen <100*10E6/L) na behandeling secundaire profylaxe, zie onder.

General comments

Infectie is zelflimiterend in immuuncompetente patiënten. Niet behandelen als er geen (ernstige) klachten zijn.

Secundaire profylaxe opties (tot CD4+ >200*10E6/L).:

1e keuze; cotrimoxazol po 960 mg, 3x per week

2e keuze: ciprofloxacine po 500mg, 3x per week

2e keuze alternatief: pyrimethamine po 25 mg 1x/week (=1 tablet Fansidar®)

Ciprofloxacine bij kinderen alleen op strikte indicatie toepassen in verband met een relatief groter risico van artropathie.

Sources

  1. Pubmed.gov publication # 10836915

    Verdier RI, Fitzgerald DW, Johnson WD Jr, Pape JW. (2000) Trimethoprim-sulfamethoxazole compared with ciprofloxacin for treatment and prophylaxis of Isospora belli and Cyclospora cayetanensis infection in HIV-infected patients. A randomized, controlled trial. Ann Intern Med. 2000 Jun 6;132(11):885-8.

  2. Pubmed.gov publication # 3261956

    Weiss et al. Isospora belli Infection: Treatment with Pyrimethamine. Annals of Internal Medicine. 1988;109:474-475.

  3. https://aidsinfo.nih.gov/guidelines

    Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR. RR March 24, 2009 / 58(Early Release);1-198.

Antimicrobial resources

The following antimicrobial agents have been used in these recommendations:

External antimicrobial resources
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Metadata

Swab vid: G-498902.2
Updated: 12/01/2023 - 17:21
Status: Published