Table 2.

Available drug options for toxoplasmosis

Medication	Adult dose	Pediatric dose
Pyrimethamine	Loading dose: 100 mg (1st day) Treatment dose: 25 mg twice daily for 4–6 weeks	1. Infants 1 mg/kg once daily for 1 year 2. Children Loading dose: 2 mg/kg/day divided into 2 daily doses for 1–3 days (maximum: 100 mg/day) Treatment dose: 1 mg/kg/day divided into 2 doses for 4 weeks; (maximum: 25 mg/day)
Folinic acid	15 mg daily	5 mg every 3 days
Trimethoprime—sulfamethoxazol	One tablet twice daily for 4–6 weeks	6–12 mg TMP/kg/day in divided doses every 12 h
Sulfadiazine	4 g daily divided every 6 h	3. Congenital toxoplasmosis Newborns and Children < 2 months: 100 mg/kg/day divided every 6 h Children > 2 months: 25–50 mg/kg/dose 4 times/day 4. Toxoplasmosis in children > 2 months Loading dose: 75 mg/kg Treatment dose: 120–150 mg/kg/day, divided every 4–6 h (maximum dose: 6 g/day)
Clindamycin	150–450 mg/dose every 6–8 h (maximum dose: 1.8 g/day) (usually 300 mg every 6 h)	8–25 mg/kg/day in 3–4 divided doses
Azithromycin	Loading dose: 1 g (1st day) Treatment dose: 500 mg once daily for 3 weeks	Children ≥ 6 months: 10 mg/kg on first day (maximum: 500 mg/day) followed by 5 mg/kg/day once daily (maximum: 250 mg/day)
Spiramycin	2 g per day in two divided doses	15 kg = 750 mg 20 kg = 1 g 30 kg = 1.5 g
Atovaquone	750 mg every 6 h for 4–6 weeks	40 mg/kg/day divided twice daily (maximum dose: 1500 mg/day)
Tetracycline	Loading dose: 500 mg every 6 h (first day) Treatment dose: 250 mg every 6 h for 4–6 weeks	Children > 8 years: 25–50 mg/kg/day in divided doses every 6 h
Minocycline	100 mg every 12 h not to exceed 400 mg/24 h for 4 to 6 weeks	Children > 8 years Initial: 4 mg/kg followed by 2 mg/kg/dose every 12 h (Oral, I.V.)

g, gram; I.V., intravenous, kg, kilogram; mg, milligram, TMP, trimethoprime

Modified from Bonfioli and Orefice [123] and readjusted according to the protocols of the Department of Ophthalmology (Ocular Inflammation Service) of the University Hospital of Ioannina, Greece