Show Menu

Antifungal Therapy Cheat Sheet by

Fungal Infections

"­Opp­ort­unistic Infect­ion­s":
- Wide spread use of broad spectrum of Antibi­otics
- Elderly
- HIV patients
- Diabetic patients
- Immuno­sup­pre­ssants and cancer chemot­herapy patients
- Pregnant women
- Burn wound victims

Fungal Infection Treatments

Superf­icial Fungal Infect­ions:

Dermat­omy­coses: skin, hair, nails (onych­omy­coses)
- Candid­iasis
- Tinea versicolor
- Dermat­oph­ytoses


- Trich­oph­yton, Micros­porum, Epider­mop­hyton
- Tinea capitis
- Tinea cruris
- Tinea pedis
- Tinea corporis (Tre­atm­ent: Clotri­mazole 2% cream, apply tds for 2 weeks after lesion has cleared)
Clinical Featur­es:
- Itchy ring-like patches
- Raised borders
- Patches slowly grow bigger = as patches extend, a clear area develops in the center which may become hyperp­igm­ented in dark skin.

Tinea Versic­olor:

- also implicated for dandruff/ seborr­hoeic dermat­ittis
- Selenium sulphide (Selsun)
- Zinc pyrithoine (Head and Shoulders)
- Soap: Sulphur (10%) and Salicylic acid (3%)

Oral Candid­iasis (Thrush):

- Presents: painful creamy white patches, can be scraped off tongue and buccal mucosa.
- Common in healthy babies (up to 1mo)
- Risk Factors: Poor Oral Hygiene, Immuno­sup­pre­ssion, Prolonged use of broad spectrum antibi­otics or cortic­ost­eroids (including inhaled), Certain chronic diseases, Trauma
- General Measur­es: Identify underlying cause, Improve oral hygiene, Ensure proper fitting dentures
- Nystatin suspen­sion, oral, 100 000 IU/mL, 1ml, 6 hourly after each meal/feed for 7 days.
= Keep in contact with affected area for as long as possible prior to swallowing
= In older children, ask child to swirl in mouth prior to swallowing
= In infants: apply to front of mouth and spread around mouth with clean finger
= continue for 48hrs after cure

Tinea Capitis:

Round or patchy bald areas with scales and stumps of broken of hair
Avoid shaving head in children
Don't share combs and hair brushes = Contagious
- Children: Flucon­azole, oral, 6mg/kg once daily for 28 days
- Adults: Flucon­azole, oral, 200mg once daily for 28 days

Systemic (Disse­min­ated) Fungal Infect­ions:

- Crypto­coccal meningitis
- Candid­iasis
- Pulmonary asperg­illosis
- Histop­las­mosis

Candida Oesoph­agitis:

- Oesoph­ageal involement in HIV infected patients with oral candid­iasis who have pain or difficulty swallowing
- Maintain hydration
- Flucon­azole 200,g po daily for 14 days
- Refer: unable to swallow, poor response to flucon­azole

Antifu­ngal: Mechanisms of Action

Classes of Antifungal Treatment

Amphot­eracin B:

- Drug of Choice of severe systemic mycoses
- pks: admini­stered IV, eliminated slowly in urine
- !!neph­rot­oxi­city, hypoka­lemia
- High probab­ility of AEs: drugs tox and admini­str­ation
- NB: toxicity monitoring (dosage and duration NB)


- GI absorption is negligible
- Most of dose excreted in stool
- safe in pregnancy
- MOA: same as amphot­eracin B


Treatment for: Candid­iasis, CCM (maint­enance txt)
Pks: D-wide, CFS; Unchanged in urine (DA)

Help Us Go Positive!

We offset our carbon usage with Ecologi. Click the link below to help us!

We offset our carbon footprint via Ecologi


No comments yet. Add yours below!

Add a Comment

Your Comment

Please enter your name.

    Please enter your email address

      Please enter your Comment.

          Related Cheat Sheets

          Drug Classes & Actions : NSAIDs Cheat Sheet

          More Cheat Sheets by Carmilaa

          Principles of AMT Cheat Sheet
          Antiviral Therapy Cheat Sheet