Skip to main content
. Author manuscript; available in PMC: 2016 Mar 1.
Published in final edited form as: Pediatrics. 2015 Feb 9;135(3):e744–e748. doi: 10.1542/peds.2014-2292

Table 1.

Recommended Treatment Regimen for Naegleria fowleri Primary Amebic Meningoencephalitis

Medication Dose Route Maximum Dose Duration Comments
Amphotericin B*1 1.5 mg/kg/day in 2 divided doses IV 1.5 mg/kg/day 3 days
 then 1 mg/kg/day once daily IV 11 days 14-day course
Amphotericin B*1 1.5 mg once daily Intrathecal 1.5 mg/day 2 days
 then 1 mg/day every other day Intrathecal 8 days 10-day course
Azithromycin12 10 mg/kg/day once daily IV/PO 500 mg/day 28 days
Fluconazole3 10 mg/kg/day once daily IV/PO 600 mg/day 28 days
Rifampin1,3 10 mg/kg/day once daily IV/PO 600 mg/day 28 days
Miltefosine13 Weight < 45 kg: 50 mg BID
Weight > 45 kg: 50 mg TID PO 2.5 mg/kg/day 28 days 50 mg tablets
Dexamethasone3,24 0.6mg/kg/day in 4 divided doses IV 0.6mg/kg/day 4 days
*

Conventional amphotericin preferred.

All medications should be started in combination as soon as the diagnosis is suspected. Intrathecal amphotericin B should be initiated if the patient develops signs/symptoms of increased intracranial pressure. Miltefosine should be started once available.

Data from references 1, 3, 12, 13, and 24.