IFI therapeutics Flashcards
What are the s/sxs of cadidiasis?
Fever, tachycardia, tachypnea, chills, hypotension
What is the preferred treatment option for candidemia of unknown species?
Micafungin IV daily
What are the risk factors for candidiasis?
- Broad spectrum antibiotics use
- Central venous catheters
- TPN
- ANC </= 500 neutropenia
- Receipt of immunosuppressive agents
- Surgery
- Intra-abdominal perforation
What are the alternate treatment options if echinocandins and fluconazole doesn’t work?
- Amphotericin B
- Voriconazole
What is the treatment duration of candidemia?
Treat for 14 days after first negative blood culture
What is the initial therapy for candidemia in neutropenic patients?
Caspo, mica, or anidulafungin
What is the other option for candidemia in neutropenic patients (that is not echinofungin)?
Lipid formulation amphotericin B
What is the fungal spectrum of activity of fluconazole?
C. albicans, parapsilosis, tropicalis, lusitaniae
What is the fungal spectrum of activity of voriconazole?
C. krusei
What is the fungal spectrum of activity of echinofungins?
C. glabrata, krusei, lusitaniae, auris
What is the fungal spectrum of activity of amphotericin b?
C. parapsilosis, krusei
What are the symptoms of disseminated histo?
Fever, chills, fatigue, weight loss, night sweats, hepatosplenomegaly, cough, chest pain, dyspnea
What are the symptoms of CNS histo?
Fever, headache, seizure, mental status changes
What is the treatment for mild-moderate histo in immunocompetent host?
Itraconazole 200mg TID x3 days, then 200mg daily or BID for 6-12 weeks
What is the treatment for moderately severe-severe histo in immunocompetent host?
Lipid amphotericin B 3-5 mg/kg/day x1-2 weeks, then itraconazole 200 mg TID x3 days followed by 200 mg BID for 12 weeks
What is the treatment for moderately severe-severe disseminated histo in immunocompromised host?
Same as Kania’s lecture
What is the treatment for mild-moderate disseminated histo in immunocompromised host?
Same as Kania’s lecture
What does coccidioidomycosis present as?
Primary respiratory infection
What are the criteria for severe coccidioidomycosis?
- Weight loss >10%
- Intense night sweats persisting >3 weeks
- Infiltrates in one half of lung or portions of both lungs
- Complement fixation antibody titers >1:16
- Inability to work or sxs that last >2 months
What is the DoC for coccidioidomycosis primary respiratory infection?
Fluconazole 400-800 mg PO/IV daily
What is the DoC for coccidioidomycosis symptomatic chronic cavitary pneumonia?
Fluconazole 400-800 mg PO/IV daily
What is the treatment duration for coccidioidomycosis?
12 months
How is cryptococcus meningitis diagnosed?
Perform a lumbar puncture and look at fluid
What is the induction treatment for cryptococcal meningitis in non-HIV, non-transplant patient?
Amphotericin B + flucytosine for at least 4 weeks
