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Guidelines
Moderate to Severe PCP

Moderate to Severe PCP

Note

Room air PO₂ <70 mmHg or PAO₂-PaO₂ ≥35 mm Hg

First Line Treatment

TMP-SMX (TMP 15–20 mg and SMX 75–100 mg)/kg/day IV q6h or q8h
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May switch to PO after clinical improvement

Second Line Treatment

Pentamidine 4 mg/kg IV daily infused over ≥60 minutes

Can reduce dose to 3 mg/kg IV daily in the event of toxicities

OR

Primaquine 30 mg (base) PO daily

PLUS

Clindamycin
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  • 900 mg IV q8h, or
  • 450 mg PO q6h, or
  • 600 mg PO q8h

Duration

21 days