Sandbox carlos: Difference between revisions
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::* Locally severe or disseminated disease: | ::* Locally severe or disseminated disease: | ||
Ampho B 0.6–1 mg/kg per day x 7 days then 0.8 mg/kg every other day or liposomal ampho B 3-5 mg/kg/d IV or ABLC 5 mg/kg/d IV, until clinical improvement (usually several wks or longer in disseminated disease), followed by itra or flu for at least 1 year. | Ampho B 0.6–1 mg/kg per day x 7 days then 0.8 mg/kg every other day or liposomal ampho B 3-5 mg/kg/d IV or ABLC 5 mg/kg/d IV, until clinical improvement (usually several wks or longer in disseminated disease), followed by itra or flu for at least 1 year. | ||
Some use combination of Ampho B & Flu for progressive severe disease; controlled series lacking. | |||
::* Meningitis: | ::* Meningitis: | ||
::: Adult: | |||
:::* Preferred regimen: Fluconazole 400–1,000 mg po q24h indefinitely | :::* Preferred regimen: Fluconazole 400–1,000 mg po q24h indefinitely | ||
:::* Alternative regimen: Ampho B IV as for pulmonary (above) + 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device. OR itra 400–800 mg q24h OR voriconazole | :::* Alternative regimen: Ampho B IV as for pulmonary (above) + 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device. OR itra 400–800 mg q24h OR voriconazole | ||
Some use combination of Ampho B & Flu for progressive severe | Some use combination of Ampho B & Flu for progressive severe disease; controlled series lacking. | ||
:::*Child | |||
:::* Preferred regimen: Fluconazole (po) (Pediatric dose not established, 6 mg per kg q24h used) | |||
:::* Alternative regimen: Ampho B IV as for pulmonary (above) + 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device. OR itra 400–800 mg q24h OR voriconazole | |||
==References== | ==References== | ||
{{reflist}} | {{reflist}} | ||
Revision as of 15:42, 21 July 2015
- Coccidioidomycosis
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- 1.Primary pulmonary in pts with increased risk of complications or dissemination.
- Mild to moderate severity:
- Itraconazole solution 200 mg po or IV bid OR
- Fluconazole 400 mg po q24h for 3–12 mo
- Locally severe or disseminated disease:
Ampho B 0.6–1 mg/kg per day x 7 days then 0.8 mg/kg every other day or liposomal ampho B 3-5 mg/kg/d IV or ABLC 5 mg/kg/d IV, until clinical improvement (usually several wks or longer in disseminated disease), followed by itra or flu for at least 1 year. Some use combination of Ampho B & Flu for progressive severe disease; controlled series lacking.
- Meningitis:
- Adult:
- Preferred regimen: Fluconazole 400–1,000 mg po q24h indefinitely
- Alternative regimen: Ampho B IV as for pulmonary (above) + 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device. OR itra 400–800 mg q24h OR voriconazole
Some use combination of Ampho B & Flu for progressive severe disease; controlled series lacking.
- Child
- Preferred regimen: Fluconazole (po) (Pediatric dose not established, 6 mg per kg q24h used)
- Alternative regimen: Ampho B IV as for pulmonary (above) + 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device. OR itra 400–800 mg q24h OR voriconazole
==References==