Fluconazole: Difference between revisions

Revision as of 16:38, 21 August 2020

Antifungal in the triazole family with excellent bioavadilability but limited efficacy outside of Candida

Species	ECV (μg/mL)	Breakpoints (μg/mL)				Breakpoints (mm)
Species	ECV (μg/mL)	S	I	SDD	R	S	I	SDD	R
Candida albicans	0.5	≤2	—	4	≥8	≥17	—	14-16	≤13
Candida dubliniensis	0.5
Candida glabrata	8	—	—	≤32	≥64	—	—	≥15	≤14
Candida guilliermondii	8
Candida krusei		intrinsically resistant				intrinsically resistant
Candida lusitaniae	1
Candida parapsilosis	1	≤2	—	4	≥8	≥17	—	14-16	≤13
Candida tropicalis	1	≤2	—	4	≥8	≥17	—	14-16	≤13
Cryptococcus neoformans	8
Cryptococcus gattii	16-32

Best side effect profiles of the antifungals
Before starting, check:
- Liver enzymes as baseline (hepatitis)
- Creatinine (requires renal dosing)
- EKG (QTc prolongation)
Beware drug-drug interactions, especially with new DOACs

@@ Line 10: / Line 10: @@
 *Efficacy predicted by AUC/MIC ratio
+=== Breakpoints ===
 {| class="wikitable"
 ! rowspan="2" |Species
+! rowspan="2" |ECV (μg/mL)
 ! colspan="4" |Breakpoints (μg/mL)
 ! colspan="4" |Breakpoints (mm)
@@ Line 25: / Line 27: @@
 |-
 |[[Candida albicans]]
+|0.5
 |≤2
 |—
@@ Line 33: / Line 36: @@
 |14-16
 |≤13
+|-
+|[[Candida dubliniensis]]
+|0.5
+|
+|
+|
+|
+|
+|
+|
+|
 |-
 |[[Candida glabrata]]
+|8
 |—
 |—
@@ Line 43: / Line 58: @@
 |≥15
 |≤14
+|-
+|[[Candida guilliermondii]]
+|8
+|
+|
+|
+|
+|
+|
+|
+|
 |-
 |[[Candida krusei]]
+|
 | colspan="4" |intrinsically resistant
 | colspan="4" |intrinsically resistant
+|-
+|[[Candida lusitaniae]]
+|1
+|
+|
+|
+|
+|
+|
+|
+|
 |-
 |[[Candida parapsilosis]]
+|1
 |≤2
 |—
@@ Line 59: / Line 98: @@
 |-
 |[[Candida tropicalis]]
+|1
 |≤2
 |—
@@ Line 67: / Line 107: @@
 |14-16
 |≤13
+|-
+|[[Cryptococcus neoformans]]
+|8
+| colspan="8" rowspan="2" |
+|-
+|[[Cryptococcus gattii]]
+|16-32
 |}