28
Management
Table 9A. Antibiotic Prophylaxis for Selected IEI
a
IEI
Indication for
prophylaxis Drug regimen
CGD Severe bacterial
infection:
pneumonia, skin
abscess
TMP/SMX (5 mg/kg max dose 160 mg
TMP component twice daily)
Alternatives: cephalosporins
Invasive aspergillosis
(lung, bone)
Itraconazole 5 mg/kg daily, max daily dose
100 mg (<50 kg ), 200 mg (>50 kg )
All infections
IFN-γ 50 μg/m
2
(min 1.5 μg ) subcutaneous
injection 3 d/wk
SCID,
congenital
athymia
Pneumocystis
pneumonia
TMP/SMX (5 mg/kg max dose 160 mg
TMP component 2–3 times/week
Alternatives: pentamidine, atovaquone,
dapsone
Candidiasis, fungal
infection
Fluconazole 3 mg/kg
Prevention/
treatment of CMV
viremia, pneumonia,
hepatitis, central
nervous system
(CNS) infection
Acyclovir 12.5 mg/kg/day Ganciclovir
Valganciclovir 16 mg/kg/day
Treat until infant is CMV PCR negative
weekly × 4
Antibody
deficiencies
Respiratory
infections
Azithromycin (5 mg/kg/d max of 250 mg
daily or 500 mg 3d/wk)
Alternatives: Amoxicillin TMP/SMX
Terminal
complement
defects or asplenia
Sepsis, meningitis
with encapsulated
bacteria
Amoxicillin or penicillin daily or through
5y of age
STAT3/IL-6–
related HIES
Bacterial infection TMP/SMX dose 5–6 mg/kg/d of TMP
component (divided BID)
Chronic
mucocutaneous
infection
Fluconazole (if not on itraconazole or other
triazoles)
5 mg/kg
Prophylaxis against
aspergilloma
Itraconazole 5 mg/kg daily, (max 100 mg/d
<50 kg, 200 mg/d >50 kg )
Treat if pneumatocele present
