Template:ID-Fungal meningitis: Difference between revisions
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::* Alternative regimen: [[Fluconazole]] 400–800 mg PO qd (6–12 mg/kg IV q24h) {{or}} [[Voriconazole]] 400 mg PO bid for 2 doses, followed by 200 mg PO bid {{or}} [[Voriconazole]] 6 mg/kg IV q12h for 2 doses, followed by 3 mg/kg IV q12h | ::* Alternative regimen: [[Fluconazole]] 400–800 mg PO qd (6–12 mg/kg IV q24h) {{or}} [[Voriconazole]] 400 mg PO bid for 2 doses, followed by 200 mg PO bid {{or}} [[Voriconazole]] 6 mg/kg IV q12h for 2 doses, followed by 3 mg/kg IV q12h | ||
::: Note: Removal of intraventricular devices is recommended. | ::: Note: Removal of intraventricular devices is recommended. | ||
:* '''Coccidioides immitis''' | :* '''Coccidioides immitis''' | ||
Preferred | ::* Preferred regimen: [[Fluconazole]] 400 mg PO qd | ||
::* Alternative regimen: [[Itraconazole]] 200 mg PO bid–tid | |||
Alternative | |||
Revision as of 00:33, 20 June 2015
- Fungal meningitis
- Blastomyces dermatitidis[1]
- Preferred regimen: Liposomal Amphotericin B 5 mg/kg/day IV for 4–6 weeks, followed by Fluconazole 800 mg PO qd OR Itraconazole 200 mg PO bid–tid OR Voriconazole 200–400 mg PO bid for ≥12 months until CSF abnl resolves
- Candida spp.[2]
- Preferred regimen: Liposomal Amphotericin B 3–5 mg/kg/day IV ± Flucytosine 25 mg/kg PO qid for several weeks, followed by Fluconazole 400–800 mg (6–12 mg/kg) PO qd until CSF abnl resolves
- Alternative regimen: Fluconazole 400–800 mg PO qd (6–12 mg/kg IV q24h) OR Voriconazole 400 mg PO bid for 2 doses, followed by 200 mg PO bid OR Voriconazole 6 mg/kg IV q12h for 2 doses, followed by 3 mg/kg IV q12h
- Note: Removal of intraventricular devices is recommended.
- Coccidioides immitis
- Preferred regimen: Fluconazole 400 mg PO qd
- Alternative regimen: Itraconazole 200 mg PO bid–tid
- C. neoformans, HIV–infected
Induction Therapy: Preferred Regimen 1 ▸ Amphotericin B 0.7–1.0 mg/kg IV q24h for ≥2 weeks OR ▸ Liposomal Amphotericin B 3–4 mg/kg IV q24h for ≥2 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg IV q24h for ≥2 weeks PLUS ▸ Flucytosine 25 mg/kg PO q6h for ≥2 weeks Induction Therapy: Preferred Regimen 2 ▸ Amphotericin B 0.7–1.0 mg/kg IV q24h for 4–6 weeks OR ▸ Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks Induction Therapy: Alternative Regimen 1 ▸ Amphotericin B 0.7 mg/kg IV q24h for 2 weeks PLUS ▸ Fluconazole 800 mg PO q24h for 2 weeks Induction Therapy: Alternative Regimen 2 ▸ Fluconazole 1200 mg PO q24h for 6 weeks PLUS ▸ Flucytosine 100 mg/kg PO q24h for 6 weeks Induction Therapy: Alternative Regimen 3 ▸ Fluconazole 800–2000 mg PO q24h for 10–12 weeks Induction Therapy: Alternative Regimen 4 ▸ Itraconazole 200 mg PO q12h for 10–12 weeks Consolidation Therapy ▸ Fluconazole 400 mg PO q24h for 8 weeks Maintenance Therapy ▸ Fluconazole 200 mg PO q24h for ≥1 year OR ▸ Itraconazole 400 mg PO q24h for ≥1 year OR ▸ Amphotericin B 1.0 mg/kg/week IV for ≥1 year
- C. neoformans, Organ Transplant Recipients
Induction Therapy: Preferred Regimen ▸ Liposomal Amphotericin B 3–4 mg/kg IV q24h for ≥2 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg IV q24h for ≥2 weeks PLUS ▸ Flucytosine 25 mg/kg PO q6h for ≥2 weeks Induction Therapy: Alternative Regimen ▸ Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks Consolidation Therapy ▸ Fluconazole 400–800 mg PO q24h for 8 weeks Maintenance Therapy ▸ Fluconazole 200–400 mg PO q24h for 6–12 months
- C. neoformans, Non–HIV-Infected and Nontransplant Hosts
Induction Therapy: Preferred Regimen ▸ Amphotericin B 0.7–1.0 mg/kg IV q24h for 4–6 weeks OR ▸ Liposomal Amphotericin B 3–4 mg/kg IV q24h for 4–6 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg IV q24h for 4–6 weeks PLUS ▸ Flucytosine 25 mg/kg PO q6h for 4–6 weeks Consolidation Therapy ▸ Fluconazole 400–800 mg PO q24h for 8 weeks Maintenance Therapy ▸ Fluconazole 200 mg PO q24h for 6–12 months Adapted from Clin Infect Dis. 2010;50(3):291-322.[10]
- Histoplasma capsulatum
Preferred Regimen ▸ Liposomal Amphotericin B 5 mg/kg IV q24h for 4–6 weeks FOLLOWED BY ▸ Itraconazole 200 mg PO bid–tid for ≥12 months Adapted from Clin Infect Dis. 2007;45(7):807-25.[11]
- ↑ Chapman, Stanley W.; Dismukes, William E.; Proia, Laurie A.; Bradsher, Robert W.; Pappas, Peter G.; Threlkeld, Michael G.; Kauffman, Carol A.; Infectious Diseases Society of America (2008-06-15). "Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 46 (12): 1801–1812. doi:10.1086/588300. ISSN 1537-6591. PMID 18462107.
- ↑ Pappas, Peter G.; Kauffman, Carol A.; Andes, David; Benjamin, Daniel K.; Calandra, Thierry F.; Edwards, John E.; Filler, Scott G.; Fisher, John F.; Kullberg, Bart-Jan; Ostrosky-Zeichner, Luis; Reboli, Annette C.; Rex, John H.; Walsh, Thomas J.; Sobel, Jack D.; Infectious Diseases Society of America (2009-03-01). "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 48 (5): 503–535. doi:10.1086/596757. ISSN 1537-6591. PMID 19191635.