Isosporiasis

August 2003     View PDF     En español
Reprinted from www.aidsmeds.com, US

How is isosporiasis treated?

The most effective treatment for isosporiasis is a combination of two drugs: trimethoprim and sulfamethoxazole (TMP-SMX; Bactrim™, Septra®). To treat isosporiasis, two double-strength TMP-SMX pills are taken twice a day. An alternative is one double-strength pill three times a day. TMP-SMX treatment is usually continued for two to four weeks.

Unfortunately, between 25% and 50% of HIV-positive people are allergic to the sulfur in the SMX half of TMP-SMX. Two of the main symptoms seen in people with allergic reactions to SMX are fever and rash. Very often, the allergy can be so severe that people need to stop taking SMX.

For patients who cannot tolerate SMX, the drug pyrimethamine (Daraprim®), combined with folinic acid, can be taken. This combination of drugs is used for a month.

To help control the diarrhea, perhaps in combination with antibiotic therapy, a number of anti-diarrheal drugs can be taken. This include: octreotide (Sandostatin®), diphenoxylate (Lomotil®), loperamide (Imodium®), paregoric, and Pepto-Bismol®. And because diarrhea is the direct result of intestinal inflammation caused by the infection, some non-steroidal anti-inflammatory drugs (NSAIDS) may be helpful such as ibuprofen (e.g., Advil®). Another drug that has been shown to greatly reduce diarrhea, due to its anti-inflammatory activity, is thalidomide (Thalomid®). Women who take this drug should avoid becoming pregnant; thalidomide can cause severe birth defects.

Diagnosis

LAST      NEXT

Prevention