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By Chen, Hua Suda, Katie J; Turpin, Robin S; Pai, Manjunath P; Et al Key words: Candidiasis - Cost-effectiveness analysis - Fluconazole - Pharmacoeconomics ABSTRACT Background: High-dose fluconazole is an alternative for patients with candidemia caused by Candida glabrata or other Candida species with decreased fluconazole susceptibility. However, empiric high- dose fluconazole is not currently recommended and may result in higher drug costs and toxicity. Objective: To determine the cost-effectiveness of using empiric high-dose fluconazole in intensive care unit (ICU) with suspected invasive candidiasis. Design: Decision analytic model. Target population: ICU patients with suspected invasive candidiasis. Time horizon: Lifetime. Perspective: Societal. Interventions: Low-dose fluconazole (loading dose of 800 mg followed by 400 mg daily) vs. high-dose fluconazole (loading dose of 1600 mg followed by 800 mg daily). Generic fluconazole costs were used for the analysis. Outcome measures: Incremental ...
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TY - JOUR. T1 - Cystoid macular edema secondary to fluconazole toxicity. AU - Magrath, George N.. AU - Pulido, Jose S.. AU - Montero, Javier. AU - Mason, Craig. AU - Wilson, John. PY - 2010/12/1. Y1 - 2010/12/1. N2 - Fluconazole is an antifungal commonly used to treat Coccidioides immitis, but this medication has a number of side effects including fatigue, rash, headache, dizziness, nausea, vomiting, diarrhea, and elevated liver enzymes. We are unaware of any cases of retinal toxicity related to fluconazole. In this case we present a 76 year old woman with longstanding Coccidioides treated with high dose fluconazole. She becomes symptomatic with fluconazole toxicity and subsequently develops bilateral cystoid macular edema. As her dose of fluconazole is decreased and she is transitioned to voriconazole the edema resolves and her visual acuity improves. This patients clinical course illustrates retinal toxicity may present with high and prolonged doses of fluconazole.. AB - Fluconazole is an ...
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Background: The association of alopecia with fluconazole was first noted by Pappas et al, and it was speculated by others these effects were possibly related to an unidentified P450 interaction between fluconazole and retinoic acid derivatives given the "retinoid-like" toxicity profile of hair loss, dry skin and mucus membranes, and nail changes observed in some patients on fluconazole. We sought to evaluate the hair-cycle specific changes of fluconazole in a rat model and to determine if any association with retinoic acid levels was noted in the model or a clinical cohort. Methods: Male Wistar rats weighing 200-220 gm (Charles River Laboratories) were fed a standard diet. Rats were randomized 1:1 to fluconazole (35 mg/kg/day) or no fluconazole and sacrificed on days 0, 7, 14, 21, 28, 35, 42, 49, 56, 63, and 70. Fifty hair samples from the caudal and 50 from the cranial aspect were obtained for microscopic examination at each time point. Plasma, skin, liver, and brain samples were obtained at ...
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TY - JOUR. T1 - Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants. T2 - A randomized clinical trial. AU - Benjamin, Daniel K.. AU - Hudak, Mark L.. AU - Duara, Shahnaz. AU - Randolph, David A.. AU - Bidegain, Margarita. AU - Mundakel, Gratias T.. AU - Natarajan, Girija. AU - Burchfield, David J.. AU - White, Robert D.. AU - Shattuck, Karen E.. AU - Neu, Natalie. AU - Bendel, Catherine M.. AU - Kim, M. Roger. AU - Finer, Neil N.. AU - Stewart, Dan L.. AU - Arrieta, Antonio C.. AU - Wade, Kelly C.. AU - Kaufman, David A.. AU - Manzoni, Paolo. AU - Prather, Kristi O.. AU - Testoni, Daniela. AU - Berezny, Katherine Y.. AU - Smith, P. Brian. PY - 2014/1/1. Y1 - 2014/1/1. N2 - IMPORTANCE: Invasive candidiasis in premature infants causes death and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole are unknown. OBJECTIVE: To evaluate the efficacy and safety of fluconazole in preventing ...
Product Name: Fluconazole Tablets. Common Name: antifungal tablets. Strength: 150 mg. Description:. Fluconazole is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. In a bulk powder form, it appears as a white crystalline powder, and it is very slightly soluble in water and soluble in alcohol.. Fluconazole is a first-generation triazole antifungal medication.. Indications and Usage:. Fluconazole is used to treat vaginal yeast infections. It works by stopping the growth of common types of vaginal yeast (fungus). This medication belongs to a class of drugs called azole antifungals. Fluconazole is used to treat a variety of fungal infections, especially Candida infections of the vagina (yeast infections), mouth, throat, and bloodstream. It is also used to prevent infections in people with weak immune systems, including those with neutropenia due to cancer chemotherapy, transplant patients, and premature babies.. Features:. Hygienically ...
Should you be plagued by a fungal infection and you immediately need an effective antifungal, then you could try using fluconazole 150 mg. Fluconazole 150 mg is commonly known in the medical world as an effective antifungal drug that can be given to the patient orally (by mouth) or intravenously (by injecting in the vein). Fluconazole 150 mg is extremely helpful in curing a huge variety of infections caused by fungi species, especially in cases of Candida infections located in the mouth (thrush), throat, bloodstream, and vagina (yeast infection). Fluconazole 150 mg is also helpful for people who have very weak immune systems and it helps such people to avoid getting infections. Examples of people who have compromised or weak immune systems include those who have undergone transplant operations, those who have neutropenia because of chemotherapy due to cancer, and it can even help keep premature babies fungal infection-free. Fluconazole 150 mg simply works by interfering or obstructing with the ...
The dose of fluconazole is mainly based on the severity and nature of the infection-causing fungi. If the treatment of the fungal infection requires multiple doses of fluconazole, then it should be continuous up until the lab tests or clinical parameters have indicated that the activity of the fungal infection has ceased. If the treatment is inadequate (abrupt cessation), then this can result to a recurrence of the fungal infection.. Fluconazole 150 mg can be given to patients who have acute vaginal candidiasis or candidal balanitis, as a single dose. As for prophylaxis and treatment of recurrent vaginal candidiasis (about 4 or more times a year), then the patient has to take fluconazole 150 mg every 3rd day for a total of 3 doses (days 1, 4 and 7), and then followed by another 150 mg once per week for the maintenance dose, which shall be taken for up to 6 months.. Fluconazole 150 mg is sold worldwide as a solitary 150-mg dose and can be availed as an over the counter drug. Depending on the ...
Oropharyngeal candidiasis (OPC) occurs in up to 93% of persons with human immunodeficiency virus (HIV) infection at some time during the course of their illness. OPC usually responds well to initial antifungal therapy, but with increasing immunodeficiency it usually recurs and can become resistant to clinical and microbiologic cure. Therapy usually begins with topical agents, followed by systemic therapy with azole antifungals when those fail. Amphotericin B is also used, but is less well tolerated and usually only effective in parenteral form. Because of its bioavailability and efficacy, fluconazole has become the most commonly used agent in treating OPC. Recurrences have often led to frequent re-treatment or prophylactic therapy with fluconazole. Daily prophylaxis with fluconazole (200 mg) has been shown to decrease the incidence of OPC. With the widespread and prolonged use of fluconazole reports of clinical failures and yeasts with decreased susceptibilities have appeared. This resistance ...
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Increased fluconazole resistance has been noted in oral C. albicans isolates from patients with very advanced AIDS who have been receiving fluconazole over long periods. Both the acquisition of new strains and increased resistance in prior strains have been noted (4, 6, 14). Multiple mechanisms of resistance have been reported, including mutations in the gene coding for the azole target enzyme, C14 sterol demethylase, and increased transcription of multidrug efflux transporters (19, 21). As in the case for AIDS, one of us has previously identified two transplant recipients whose C. albicans isolates became resistant to fluconazole and who developed deep infections (11, 12). The isolates for these patients exhibited increased expression of efflux pumps (12). Isolates from one of these patients developed drug resistance in a little over 2 weeks, similar to the findings reported here for C. glabrata, for which the MIC doubled an average of every 31 days. Although we did not attempt to assess the ...
To treat thrush (yeast infection of the mouth and throat), the recommended adult dose is 100 mg taken by mouth once daily for at least 2 weeks.. To treat esophageal candidiasis (yeast infection of the tube leading to the stomach), the recommended adult dose ranges from 100 mg to 200 mg taken daily for at least 3 weeks. Fluconazole must be taken for at least 2 weeks after the symptoms of the infection resolve to prevent the infection from returning.. To treat yeast infection that has spread throughout the body (disseminated yeast infection), the recommended adult dose of fluconazole is 200 mg to 400 mg once daily, for at least 4 weeks. Again, this medication must be taken for at least 2 weeks after the symptoms of the infection resolve to prevent the infection from returning.. To treat cryptococcal meningitis, the recommended dose of fluconazole is 200 mg to 400 mg once daily. Fluconazole should be taken for at least 10 weeks when treating this condition. To prevent cryptococcal meningitis, 200 ...
The American Academy of Pediatrics (AAP) has updated the 2018 edition of the Red Book to include fluconazole dosing information determined by a Pediatric Trials Network (PTN) study. The Red Book is the leading resource on pediatric infectious disease, providing the most up-to-date information on a wide variety of diseases that doctors see in children.. The updates include dosing information for the treatment of Cryptococcus neoformans and Cryptococcus gattii infections, as well as Cryptococcal meningitis in children. The updates, which can be viewed on Red Book Online, will enable doctors to provide a safer, more accurate dose of the antifungal drug fluconazole to treat these diseases in children.. The changes were based on a study conducted from 2008 to 2011 in collaboration with PTN that analyzed safety data on the use of fluconazole to treat infections caused by the Candida yeast. While Candida and Cryptococcus yeasts are not the same, they are treated similarly enough to allow dosing ...
Objectives: (1) To determine the pharmacokinetics of sequential intravenous and enteral fluconazole in the serum of surgical intensive care unit (ICU) patients with deep mycoses. (2) To determine the concentrations of fluconazole reached at the site of infection. (3) To determine if enteral administration of fluconazole, which has an important pharmaco-economic advantage, is justified in this specific patient group.Design: Descriptive, sequential study as a part of a therapeutic drug monitoring programme.Setting: Eighteen-bed surgical ICU in a referral centre.Patients: Fourteen critically ill surgical patients with recent gastro-intestinal (GI) surgery and deep mycosis caused by a fluconazole-susceptible fungus and a calculated creatinine clearance of more than 40 ml/min.Interventions: Fluconazole dosage regimen: 400 mg i.v. every 24 h with an extra dose of 400 mg i.v. after 12 h on day 1. If the clinical condition allowed enteral administration on day 4, the content of two capsules of 200 mg ...
Fluconazole is an antifungal medication used in the treatment of several fungal infections. The drug is used orally and intravenously. Fluconazole widely distributes into body tissues, nails and fluids including saliva, sputum, vaginal secretions. Fluconazole does not undergo first pass metabolism and is excreted mostly in the urine and some in the feces. This drug can also be used in the pediatric population.. Mechanism: Fluconazole works by altering the fungal cell membrane. It exerts its fungistatic effect by selectively inhibiting 14-alpha demethylase. This is a cytochrome P-450 enzyme that is necessary for synthesizing ergosterol, which is an important component of the fungal cell membrane. 14-alpha demethylase converts lanosterol to ergosterol. Without ergosterol, 14 alpha-methyl sterols increase which subsequently causes the fungal cell membrane to exhibit increased cellular permeability. This causes the components inside the cell to leak.. Uses: With its unique mechanisms of action, ...
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PRIMARY OBJECTIVES:. I. To determine if caspofungin (caspofungin acetate) is associated with a lower incidence of proven/probable invasive fungal infections (IFI) during the first 42 days following allogeneic hematopoietic cell transplantation (HCT) at high-risk for IFI compared with azole (fluconazole or voriconazole) prophylaxis.. SECONDARY OBJECTIVES:. I. To determine if caspofungin is associated with a lower incidence of proven/probable IFI during the first 100 days following high-risk allogeneic HCT compared with azole (fluconazole or voriconazole) prophylaxis. (Exploratory) II. To determine if caspofungin is associated with a lower incidence of proven/probable IFI during the first 42 and 100 days following high-risk allogeneic HCT compared with fluconazole prophylaxis. (Exploratory) III. To determine if caspofungin is associated with a lower incidence of proven/probable IFI during the first 42 and 100 days following high-risk allogeneic HCT compared with voriconazole prophylaxis. ...
Candidiasis has become an important concern for clinical practice, especially with the increasing incidence of immunocompromised patients. In this scenario, the development resistance to fluconazole presents a challenge for treating these opportunistic infections. The aim of this study was to evaluate some epidemiology features of Candidainfections in a Brazilian University Hospital using data, previously unavailable. We observed that 44% of the 93 clinical isolates tested, belonged to Candida albicansspecies and 56% belonged to non-Candida albicansspecies (mainly Candida tropicalis and Candida glabrata). Most strains were isolated from urine samples where C. albicans was predominantly detected. 29 strains presented a fluconazole resistance phenotype and of these, 22 were chemosensitised by FK506, a classical inhibitor of ABC transporters related to azoles resistance. These data suggest the probable role of efflux pumps in this resistance phenotype. Our study highlights the need for developing ...
The team studied 1,405,633 pregnancies in Denmark from 1997-2013 and compared each fluconazole-exposed pregnancy with up to four that were not exposed, matching the study subjects on maternal age, calendar, and gestation age. Researchers were able to determine filled fluconazole prescriptions through the countrys National Prescription Register.. Pregnant women have a greater chance of developing a yeast infection called vaginal candidiasis due to their increased secretion of sex hormones. Intravaginal formulations of topical azole antifungals are the first-choice treatment for pregnant women, but oral fluconazole is also widely used. There is a lack of safety information on this drug, with previous studies suggesting evidence of a distinct pattern of craniofacial and skeletal birth defects in babies born to women who were treated long-term with high dose fluconazole during their pregnancy. Almost 10% of US women develop intravaginal candidiasis during pregnancy. ...
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Twenty-three monoketone derivatives of curcumin were synthesized to investigate the synergy with fluconazole against fluconazole-resistant Candida spp. The minimal inhibitory concentration (MIC80) and the fractional inhibitory concentration index (FICI) of the antifungal synergist fluconazole were measured a
FLUCONAZOLE IN SODIUM CHLORIDE, INDICATIONS AND USAGE Fluconazole is indicated for the treatment of: Oropharyngeal and esophageal candidiasis. In open noncomparative studies of relatively small numbers of patients, fluconazole was a
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Fluconazole, a bis-triazole with activity similar to that of ketoconazole, is water-soluble and can be given both orally and intravenously. Absorption of the medication after oral administration is not pH-dependent. It penetrates well into the cerebrospinal fluid and eye. The medication has been shown to be effective primarily in the treatment of Candida, Cryptococcus, and Blastomyces infections. Candida albicans, C tropicalis, and C parapsilosus are usually sensitive to fluconazole, but many other species of Candida (C krusei, C glabrata, etc) are often resistant. Fluconazole-resistant strains of C albicans primarily have been observed in patients receiving antecedent fluconazole therapy. The medication is inactive against Aspergillus, Mucor, and Pseudallescheria. Fluconazole is effective in oropharyngeal candidiasis and candidal esophagitis. It is as effective or more effective than vaginal creams and suppositories in vaginal candidiasis; a single oral dose of fluconazole 150 mg is 80-90% ...