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 |
|
