Trypanosomiasis: Treatment, summary

T. b. gambiense: early stage:

• Or DFMO 100 mg/kg IV 4 times per day for 14 days

• Or Pentamidine 4 mg base/kg/day IM on days 1 to 7

• Or Suramin test dose 5 mg/kg, then 20 mg/kg/day (max. 1 g) IV on days 3, 10, 17, 24, 31

• Or Pentamidine 4 mg base/kg IM on days 1, 3, 13, 15, 17 + Suramin 20 mg/kg on days 1 and 13

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T. b. gambiense, late stage:

• Or DFMO 100 mg/kg IV 4 times per day for 14 days

• Prednisolone 1 mg/kg, starting 1 day before the rest of the medication, followed by

• Suramin or Pentamidine 1 to 2 injections, followed by

• Arsobal 3-4 series of one injection per day for 3-4 days with 7-10 days’ rest period in between

• Or Arsobal 2.2 mg/kg/day for 10 days with prednisolone throughout the whole period

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T. b. rhodesiense

• Suramin test dose (check urine for protein and cylinders), then 1 g per week for 6 weeks. The first dose can be given fractionated over 2 days. Quicker alternative scheme: days 1, 3, 6, 14, 21

• Arsobal may be supplemented with prednisolone

• A high (double) dose of DFMO gives a favourable result in 50% of cases, if combined with suramin

Category: Medicine Notes