IDSA Recommendations for Preventing and Treating Toxoplasma gondii Encephalitis in HIV-AIDS

Indications for Initiating Primary Prophylaxis:

 • Toxoplasma IgG positive patients with CD4 count <100 cells/mm3

Preferred Regimen:

 • TMP-SMX 1 DS PO daily 

Alternative Regimens:

 • TMP-SMX 1 DS PO three times weekly or

 • TMP-SMX SS PO daily or

 • Dapsone 50 mg PO daily + (pyrimethamine 50 mg + leucovorin 25 mg) PO weekly or

 • Atovaquone 1500 mg PO daily 



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