Sandbox carlos

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  • 1. Cystoisospora belli treatment


  • 2. Cystoisospora belli prophylaxis
  • 2.1 Primary prophylaxis
  • Insufficient evidence is available to support a general recommendation for primary prophylaxis for Cystoisosporiasis per se, especially for U.S. travelers in isoporiasis-endemic areas.
  • 2.2 Secondary prophylaxis (preventing recurrence in patients with CD4 count < 200 cells/mm3)
  • Prefered regimen: Trimethoprim-sulfamethoxazole 160 mg/800 mg PO 3 times weekly
  • Alternative regimen (1): Trimethoprim-sulfamethoxazole 160 mg/800 mg PO qd
  • Alternative regimen (2): Trimethoprim-sulfamethoxazole 320 mg/1600 mg PO 3 times weekly
  • Alternative regimen (3): Pyrimethamine 25 mg PO qd AND Leucovorin 5–10 mg PO qd
  • Alternative regimen (4): Ciprofloxacin 500 mg PO 3 times weekly
  • Note (1): Criteria for discontinuation of chronic maintenance therapy: sustained increase in CD4 count > 200 cells/mm3 for > 6 months in response to ART and without evidence of active Cystoisospora belli infection
  • Note (2): Because of concerns about possible teratogenicity associated with first-trimester drug exposure, clinicians may withhold secondary prophylaxis during the first trimester and treat only symptomatic infection.


  • Immunocompetent
  • 1. Patients with sulfa intolerance
  • Alternative regimen (1): Pyrimethamine 50-75 mg PO daily AND Leucovorin 10–25 mg PO daily
  • Alternative regimen (2): Ciprofloxacin 500 mg PO BID for 7 days


  • HIV
  • 1. Patients with CD4 Count <200/mm3 (chronic treatment)


References