Non-severe infection | |
Isolated cutaneous infection | TMP-SMX 5 to 10 mg/kg orally of the trimethoprim component per day in two divided doses (first-line regimen) |
OR | |
Minocycline 100 mg orally twice daily (alternative regimen) | |
Non-severe mycetoma | TMP-SMX 10 mg/kg orally of the trimethoprim component per day in two divided doses +/- |
Dapsone 100 mg orally once daily | |
Mild or moderate pulmonary disease in immunocompetent hosts | TMP-SMX 5 to 10 mg/kg orally of the trimethoprim component per day in two divided doses |
Mild or moderate pulmonary disease in immunocompromised hosts | TMP-SMX 15 mg/kg orally of the trimethoprim component per day in three or four divided doses |
Severe infection | |
Severe mycetoma | Imipenem 500 mg IV every 6 hours +/- |
Amikacin 7.5 mg/kg IV every 12 hours | |
Severe pulmonary or disseminated disease (without CNS involvement) | TMP-SMX 15 mg/kg IV of the trimethoprim component per day in three or four divided doses PLUS |
Amikacin 7.5 mg/kg IV every 12 hours (first-line regimen) | |
OR | |
Imipenem 500 mg IV every 6 hours PLUS | |
Amikacin 7.5 mg/kg IV every 12 hours (alternative regimen) | |
Involvement of ≥2 sites in immunocompromised hosts (without CNS involvement) | TMP-SMX 15 mg/kg IV of the trimethoprim component per day in three or four divided doses PLUS |
Amikacin 7.5 mg/kg IV every 12 hours (first-line regimen) | |
OR | |
Imipenem 500 mg IV every 6 hours PLUS | |
Amikacin 7.5 mg/kg IV every 12 hours (alternative regimen) | |
Isolated CNS disease | TMP-SMX 15 mg/kg IV of the trimethoprim component per day in three or four divided doses PLUS |
Imipenem 500 mg IV every 6 hours | |
CNS disease with multiorgan involvement (ie, at least one other site) | TMP-SMX 15 mg/kg IV of the trimethoprim component per day in three or four divided doses PLUS |
Imipenem 500 mg IV every 6 hours PLUS | |
Amikacin 7.5 mg/kg IV every 12 hours | |
Life-threatening disease | TMP-SMX 15 mg/kg IV of the trimethoprim component per day in three or four divided doses PLUS |
Imipenem 500 mg IV every 6 hours PLUS | |
Amikacin 7.5 mg/kg IV every 12 hours |
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