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INVASIVE/PATHOGENIC FUNGAL INFECTIONS Cheat Sheet (DRAFT) by

This is a draft cheat sheet. It is a work in progress and is not finished yet.

HISTOP­LAS­MOSIS

ACUTE PULMONARY
Mild-Mod
Tx unnece­ssary
 
Itraco­nazole
  
For sx >1mo
Mod-Severe
Lipid AmpB
Itraconazole
(followed by)
3-5 mg/kg IV QD 1-2 wks
200mg TID x3D then 200mg BID x12wks
 
Deoxy Amp B
0.7-1.0 mg/kg IV QD
Alt for pts who are at low risk for nephro­tox­icity
 
Methyl­pre­dni­solone
0.5-1.0 mg/kg IV
During first 2 weeks of therapy
For pts who develop respir­atory compli­cations (hypoxemia or signif­icant resp. distress)
CHRONIC PULMONARY
 
Itraco­nzole
200mg x3 QD for 3 days, then 1-2 QD for a year
Take with food or soda
Obtain levels after 2 weeks to ensure proper drug exposure
 

BLASTO­MYCOSIS

PULMONARY
Mild-Mod
PO Itraconazole
200 mg TID x3 days then 200 mg 1-2/day x6-12 months
 
Amp
If hepato­toxic with Itraco­nazole
Mod-Severe
Lipid Amp B
3-5 mg/kg QD for 1-2 weeks
 
Alt: AmB Deoxy
0.7-1 mg/kg QD for 1-2 weeks
IMMUNO­COM­PRO­MISED PTS
Immunosup.
or AIDS pt
Lipid Amp B
3-5 mg/kg QD
 
Alt: AmB Deoxy
0.7-1 mg/kg QD x 1-2 weeks or until improv­ement noted
 
Step down: Itraco­nazole
200 mg QD
PREGNANT
Lipid Amp B
3-5 mg/kg QD{nl}} AVOID: azoles
NEWBORN
AmB Deoxy
1.0 mg/kg QD
CHILDREN (severe)
Mild-Mod
PO Itraco­nazole
10 mg/kg QD (max of 400 mg QD) x 6-12 months
Severe
AmB Deoxy
0.7-1.0 mg/kg QD
 
Alt: Lipid Amp B (initial)
3-5 mg/kg QD
 
Step Down: PO Itraco­naozole
10 mg/kg QD (max 400 mg QD)
Note: Lifelong suppre­ssive therapy with PO Itraco­nazole 200 mg QD if immuno­sup­pre­ssion can't be revered or if pt experience relapse

COCCID­IOD­OMY­COSIS

CHRONIC CAVITARY PNEUMONIA
Fluconazole
Itraconazole
EXTRAP­ULMARY
Fluconazole
Itraconzole
BONE AND JOINT
Azoles
 
Severe? Amp B