|
Important: Protocol superseded July 2009 - see new version here at www.edren.co.uk.
That website is in development - you can ignore the 'This website is not ready' signs ONLY for the Transplant protocols. Others are not updated or fully transferred. |
Standard prophylaxis is cotrimoxazole 480mg once daily for the first three months. If extra treatment for acute rejection has been required, prophylaxis should extend to 3 months after that treatment.
Desensitisation should be considered if patients are unable to tolerate low dose Co-trimoxazole for PCP prophylaxis.
Desensitisation protocol
First Line
Paediatric Co-trimoxazole suspension (240mg/5ml) diluted 1:20. (2.4mg/ml Co-trimoxazole).
| Day | Volume | Dose of Sulphamethoxazole |
| 1 | 1ml | 2mg |
| 2 | 2ml | 4mg |
| 3 | 4ml | 8mg |
| 4 | 8ml | 16mg |
| 5 | 12ml | 24mg |
Paediatric Co-trimoxazole suspension (240mg/5ml)
| 6 | 1.25ml | 50mg |
| 7 | 2.5ml | 110mg |
| 8 | 5ml | 240mg |
| 9 | 10ml | 480mg |
| 10 | 10ml/1 tablet | 480mg |
Second Line
Dapsone 100mg od
Consider dose reduction to 50mg od in severe renal dysfunction (reatinine clearnace <10ml/min).
Third Line
Nebulised pentamidine 300mg every 4 weeks - details from pharmacy.
Transplant protocols developed on the Edinburgh Transplant Unit. This page first published March 2002 by Amit Adlakha, updated December 2006 and
NOTE that the accuracy of any statements in this information CANNOT be guaranteed. It is published in the belief that it is correct, and we endeavour to keep it so - but we do make mistakes. Furthermore, over some subjects there are differing opinions, or differing degrees of certainty. We have usually not attempted to discuss these here because the aim has been to provide an immediate and brief guide. In all areas, prior medical knowledge is assumed. The EdRenHANDBOOK is not suitable for use by those without such a background. Contact us by email or at the address given at the foot of the contents page with any comments or corrections.