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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will Amphotericin B or Fluconazole help better to treat fungal infections?

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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3184 Questions

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Posted on Wed, 15 Mar 2017 in Brain and Spine
Question: have family outside the country with sarcoidosis now onconcious with fungus in csf . DRS not sure whether to start amphotericin B or FUCONAZOL IV

ok thanks. note he has sarcoidosis and on prednisone
doctor
Answered by Dr. Erion Spaho 28 minutes later
Brief Answer:
Fluconazol may be started.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Both antifungal drugs may be used, but optional treatment should be guided by antibiogram.

In my opinion, since fluconazol belongs to newer antifungal drugs and is taken i.v., should be used.

A brain MRI also is necessary to evaluate the extent of the fungal infection.

Hope you found the answer helpful.

Take care.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Erion Spaho 9 hours later
he is now on iv fluconazol but iam not sure if 400mg is adequate a six feet adult approximately 190lb. pls. I like to know the recommended MG/KG, HOW OFTEN eg q12 or q8 etc,how long can he be on the treatment or duration of the treatment.
I thank you for help.
doctor
Answered by Dr. Erion Spaho 10 hours later
Brief Answer:
Doses for 24 hours explained below.

Detailed Answer:
Welcome back.

Fluconazole dose varies from 6 mg/kg to 12 mg/kg/daily.

Doses to treat central nervous system involvement in adults may be from 400 to 800 mg fluconazole daily for several weeks.

However, this can be adjusted to patient's condition and this is a decision that belongs to the treating Doctor.

Hope I helped you.

Kind regards.
Above answer was peer-reviewed by : Dr. Remy Koshy
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