Specific OI Treatment and Prevention Regimens

PCP treatment; preferred therapy — dose, frequency, duration

“Tamp down, 15-20 per kg, three to four times per day; for 3 weeks.”

• SMX/TMP 15-20 mg/kg TID-QID, x 3 weeks

• Dose based on TMP component

PCP treatment; add-on therapy — how soon, duration, under what conditions to initiate

Prednisone, within 72 hours, x 3 weeks

Add-on if:

• PaO2 <70 mmHg

• AA-O2 ≥35 mmHg

PCP primary prevention; preferred therapy — dose, frequency

“Tamp down, once daily.”

• SMX/TMP, 1 DS or 1 SS tablet; PO daily

PCP primary prevention; alternative therapy options

SMX/TMP, 1 DS tablet; 3x/week

OR

Dapsone (if no G6PD* deficiency)

OR

Atovaquone

MAC treatment; preferred therapy — dose, frequency, duration

“Take Clara 500 twice per day and Ethan 15 per kg once daily; for 12 months.”

• Clarithromycin 500 mg PO BID + ethambutol 15 mg/kg PO daily; x 12 months

MAC treatment; add-on therapy — options

“For the 3rd, Re-Butin. For the 4th, Levi, Moxi, or Ivory Aminos will work.”

• 3rd drug: rifabutin — if severe MAC

• 4th drug: levofloxacin, moxifloxacin, or IV aminoglycoside — if severe MAC, high mortality risk, resistance, lack of effective ART

MAC treatment; alternative therapy

“Take Azithro 500-600 and Ethan 15 per kg once daily.”

• Azithromycin, 500-600 mg + ethambutol, 15 mg/kg PO daily

MAC primary prevention; preferred therapy, option 1 — dose, frequency

“Take Azithro 1200 once per week.”

• Azithromycin, 1200 mg PO once weekly

MAC primary prevention; preferred therapy, option 2 — dose, frequency

“Or Clara 500, twice per day.”

• Clarithromycin, 500 mg BID