IDStewardship

  • Home
  • Articles
  • LEARN ANTIBIOTICS
  • Study Guide
  • Resources
  • Q&A
  • #ASPchat
  • Contributors
  • About

Fluconazole

Intravenous fluconazole

Oral fluconazole

 

KEY POINTS

  • Fluconazole (Diflucan) is an Azole derivative antifungal drug that works by interfering with ergosterol synthesis, which is the principal sterol in the fungal cell membrane
    • Exhibits fungistatic activity versus mosts yeasts, but has fungicidal activity versus many moulds
  • Is a corner-stone in the management of Candida infections
    • Beware resistance in Candida glabrata, which may be sensitive, dose-dependent sensitive (DDS), or resistant
    • Candida krusei is inherently resistant to fluconazole
    • Other Candida species can have fluconazole resistance. Beware this in particular with patients who have a prolonged history of fluconazole exposure or who are being treated at institutions with a history of fluconazole-resistant Candida.
  • Available oral or injectable – a good drug to watch for IV to PO transition
    • Due to excellent bioavailability, fluconazole oral has been used to treat candidemia (i.e., a Candida bloodstream infection) – most oral drugs are not suitable for oral use with a bloodstream infection
  • Doses vary greatly depending on indication, from 150mg once to 800mg or more daily
    • Adjust doses for renal dysfunction
  • Beware drug-drug interactions via inhibition of CYP: 1A2, 2C19, 2C9 and 3A4
  • Beware hepatotoxicity and increases in AST/ALT

RESOURCES

  • Fluconazole Package Insert (oral and injectable)
  • IDSA Candidemia Guideline (2016)
    • Other IDSA Guidelines For Fungi
  • Guidelines For Opportunistic Infections From AIDSinfo
  • 2015 CDC Sexually Transmitted Diseases Guideline (2015)
  • Pharmacology Of Systemic Antifungal Agents (2006)
  • Current Concepts In Antifungal Pharmacology (2011)

Free Antibiotic Cheat Sheet

Study Guide

  • Pharmacotherapy Study Guide
  • Acyclovir
  • Albendazole
  • Amikacin
  • Aminoglycosides
  • Amphotericin B
  • Amoxicillin
  • Amoxicillin-Clavulanic Acid
  • Ampicillin
  • Ampicillin-sulbactam
  • Anidulafungin
  • Artesunate
  • Atovaquone
  • Azithromycin
  • Aztreonam
  • Bacitracin
  • Baloxavir marboxyl (Xofluza)
  • Bamlanivimab
  • Baricitinib
  • Bezlotoxumab
  • Casirivimab and Imdevimab
  • Caspofungin
  • Cefazolin
  • Cefepime
  • Cefiderocol
  • Ceftaroline
  • Ceftazidime
  • Ceftazidime-avibactam
  • Ceftolozane-Tazobactam
  • Ceftriaxone
  • Cefoxitin
  • Cephalexin
  • Ciprofloxacin
  • Clarithromycin
  • Clindamycin
  • Colistin (colistimethate)
  • Cycloserine
  • Dalbavancin
  • Daptomycin
  • Delafloxacin
  • Dicloxacillin
  • Doripenem
  • Doxycycline
  • Elbasvir/ grazoprevir
  • Eravacycline
  • Ertapenem
  • Erythromycin
  • Famciclovir
  • Fidaxomicin
  • Fluconazole
  • Flucytosine
  • Foscarnet
  • Fosfomycin
  • Ganciclovir
  • Gentamicin
  • Glecaprevir/ Pibrentasvir
  • Imipenem-cilastatin
  • Imipenem-cilastatin-relebactam
  • Isavuconazole
  • Itraconazole
  • Ivermectin
  • Ledipasvir/sofosbuvir
  • Lefamulin
  • Letermovir
  • Levofloxacin
  • Linezolid
  • Meropenem
  • Meropenem-vaborbactam
  • Metronidazole
  • Methenamine
  • Micafungin
  • Minocycline
  • Moxifloxacin
  • Nafcillin
  • Nitrofurantoin
  • Omadacycline
  • Oritavancin
  • Oseltamivir
  • Oxacillin
  • Penicillin
  • Penicillin Skin Test
  • Phenazopyridine
  • Piperacillin-tazobactam
  • Plazomicin
  • Polymyxin B
  • Posaconazole
  • Quinupristin-dalfopristin
  • Remdesivir
  • Ribavirin
  • Rifabutin
  • Rifampin
  • Secnidazole
  • Sofosbuvir/ velpatasvir/ voxilaprevir
  • Sulfadiazine
  • Sulfamethoxazole-Trimethoprim (Bactrim)
  • Tedizolid
  • Telavancin
  • Tigecycline
  • Tobramycin
  • Tocilizumab
  • Valacyclovir
  • Valganciclovir
  • Vancomycin
  • Voriconazole
  • Zidovudine
  • Zoster vaccine recombinant, adjuvanted (Shingrix)

Recent

  • COVID-19 Vaccine Resources For Pharmacists
  • Five Things To Know About The Antifungal Drug Pipeline
  • IDstewardship Year End Review: 2020
  • Year In Review: Top Infectious Diseases Articles Of 2020
  • An Unofficial Pharmacy Playlist Of Drug Theme Songs

Search

Copyright 2016-2020 By Charlie Rose, LLC © · IDStewardship.com · Copyright · Privacy Policy · Terms · Contact