Exam 5 Treatments

Question 1

Primary Treatments for Invasive Candida

Answer 1

Primary: Echinocandins
-Capsofungin 70 mg IV for 1 dose then 50 mg daily
-Micafungin 100 mg IV daily
-Anidulafungin 200 mg IV once then 100 mg daily
Alternative: Fluconazole 800 mg PO/IV once then 400 mg daily
DOT: at least 2 weeks from 1st (-) blood culture

Question 2

Alternative Treatment for Invasive Candida if Echinocandins not used

Answer 2

Alternative: Fluconazole 800 mg PO/IV once then 400 mg daily
DOT: at least 2 weeks from 1st (-) blood culture

Question 3

What medication is used in endocarditis due to invasive candida

Answer 3

Amphotericin B

Question 4

What medication is used in osteomyelitits due to invasive candida

Answer 4

Fluconazole

Question 5

Treatment of mild histoplasmosis

Answer 5

observation –> if no improvement after 1 month then treat 6-12 weeks with itraconazole or Fluconazole

Question 6

What medication is used in Chorioretinitis due to invasive candida

Answer 6

Fluconazole or Amphotericin B

Question 7

Treatment for mild histoplasmosis

Answer 7

observation –> if no improvement after 1 month treat with itraconazole or fluconazole for 6-12 weeks

Question 8

Treatment for severe/disseminated histoplasmosis

Answer 8

-Amphotericin B deoxy or
-Liposomal amphotericin B for 12 weeks
-Switch to itraconzole (fluconazole alternate) once stable
-consider corticosteroids for lung infection if hypoxic

Question 9

treatment of mild blastomycosis

Answer 9

observation –> if no improvement after 1 month treat with itraconazole PO daily for 3 days then BID for 6-12 months

Question 10

treatment of severe blastomycosis

Answer 10

-Amphotericin B deoxy or
-Liposomal amphotericin B for 4-6 weeks
-Switch to itraconzole (fluconazole alternate) once stable
-consider corticosteroids for lung infection if hypoxic

Question 11

Treatment for mild Coccidioidomycosis

Answer 11

observation –> if no improvement after 1 month treat with itraconazole or fluconazole 6-12 weeks

Question 12

Treatment for severe coccidioidomycosis

Answer 12

-Amphotericin B deoxy or
-Liposomal amphotericin B for 12 weeks
-Switch to fluconazole once stable
-consider corticosteroids for lung infection if hypoxic

Question 13

Skin treatment of Sporotrichosis “rose gardeners disease”

Answer 13

Itraconazole 1-6 months
potassium iodide

Question 14

CNS, Pulmonary, joints, bone treatment of Sporotrichosis “rose gardeners disease”

Answer 14

-Amphotericin B
-Itrazonazole for a year
-SURGERY if Pulmonary

Question 15

3 stages of cryptococcal meningitis treatment

Answer 15

induction
consolidation
maintenance

Question 16

Induction treatment for Cryptococcus

Answer 16

-Amphotericin B deoxy + Flucytosine or
-Liposomal amphotericin B + Flucytosine (for renal impairment)
DOT: >/= 2 weeks

Question 17

Consolidation treatment for cryptococcus

Answer 17

Fluconazole 400-800 mg PO daily (800 if non HIV)
DOT: 8 weeks

Question 18

Maintenance Treatment for Cryptococcus

Answer 18

Fluconazole 200-400 mg PO daily
DOT: 6-12 months

Question 19

Treatment for nonmeningocryptococcus

Answer 19

Fluconazole 400 mg PO for 6-12 months

Question 20

Treatment for Aspergillosis

Answer 20

Primary: Voriconazole 6 mg/kg BID for 2 doses then 4 mg/kg IV BID
Alternatives:
-liposomal amphotericin B
-Echinocandins
DOT: 6-12 weeks

Question 21

Treatment for Mucormycosis

Answer 21

-Lipid Amphotericin B 5 mg/kg IV daily
-Isovuconazole
-Posaconazole (off label)