infections
Toxoplasmosis
Treatment of Toxoplasmosis
Pyrimethamineand eithersulfadiazine,clindamycin, oratovaquone, plusleucovorin; or alternatively,trimethoprim-sulfamethoxazole For eye infections, medications effective against toxoplasmosis and a corticosteroid Most infected people without symptoms and with a healthy immune system do not require treatment. People with symptoms of toxoplasmosis can be treated withpyrimethamine,sulfadiazine, andleucovorin.Leucovorinis given to help protect against decreased blood cell production in the bone marrow, which is a side effect ofpyrimethamine. If people cannot takesulfadiazine,clindamycin, oratovaquonecan be used instead. Whenpyrimethamineis not available,trimethoprim-sulfamethoxazole is used. If people have a healthy immune system, they are usually treated for a few weeks. People with AIDS or other conditions that weaken the immune system are given the same medications but are treated longer (usually for at least 6 weeks) until all signs of infection are gone. Relapses are common, and there are several options for chronic maintenance therapy, which is continued until their immune system improves. In people with AIDS, toxoplasmosis tends to recur, so medications to control toxoplasmosis are continued indefinitely unless the immune system improves (indicated by an increase in the Monitoring to an acceptable level). Doctors make sure that the most effective antiretroviral medications are being used. People with an eye infection can be givenpyrimethamineplussulfadiazine(orclindamycin) plusleucovorin.Trimethoprim-sulfamethoxazole is an alternative.Prednisoneor another corticosteroid is usually given at the same time to reduce inflammation inside of the eye. Women who acquire toxoplasmosis during pregnancy should see a doctor who specializes in toxoplasmosis during pregnancy. The choice of medications is complicated and depends on when the pregnant woman acquired the infection (which trimester) and whether the fetus has already been infected.Pyrimethaminecan cause birth defects and is not used during the 1st trimester of pregnancy. Spiramycin (an antibiotic) may be used during the 1st trimester to help prevent the spread of toxoplasmosis from the woman to the fetus. Spiramycin is not commercially available in the United States. Newborns who were infected before birth are usually givenpyrimethamine,sulfadiazine, andleucovorinfor a year after birth. Pregnant women should avoid becoming infected with toxoplasmosis by washing hands, eating only fully cooked meat and seafood, avoiding contact with cat feces, and wearing gloves while gardening. 