Table 3.

Treatment options for Pneumocystis pneumonia.

PREFERRED OPTION
Drug	Dose and routea	Indications/other comments
TMP-SMX	15–20 mg/kg/day (TMP)	IV recommended in severe cases
	75–100 mg/kg/day (SMX)	Oral for mild and moderate cases
	IV or oral In divided doses	IV form can be switched to oral after clinical improvement
	(3–4 times a day)	Levels should be monitored
ALTERNATIVE REGIMENS
Pentamidine	4 mg/kg/day	Moderate to severe cases
	IV or IM	High incidence of toxicity
Primaquine + Clindamycin	30 mg/day orally +	Mild to moderate cases
	600 mg/three times a day	Check for G6PD deficiency prior to the use of primaquine
	IV or oral
Atovaquone	750 mg twice a day oral	Mild to moderate cases
TMP +	5 mg/kg three times a day +	Mild to moderate case
Dapsone	100 mg/day	Methemoglobinemia with Dapsone
	Oral
ADJUNCTIVE THERAPY
Prednisone	40 mg twice a day for 5 days →	Moderate to severe cases
	40 mg a day for 5 days →	Especially if hypoxemia (PaO2 ≤70 or alveolar-arterial oxygen gradient ≥35 mmHg
	20 mg a day for 11 days Oral

TMP-SMX, trimethoprim-sulfamethoxazole; IV, intravenous; IM, intramuscular.

^aRecommended duration of treatment is 21 days.