Overview of antifungal agents benefits, weaknesses, ...
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Description

Overview of antifungal agents benefits, weaknesses, and adverse effects in the treatment of Coccidioidomycosis.

Fluconazole - Low cost/tolerable

 • High MIC values in vitro

 • Hepatotoxicity, QTc prolongation, alopecia, xerosis, and cheilitis

Itraconazole - Highly efficacious and tolerable

 • CSF and bone penetration,

 • Hepatotoxicity, gastrointestinal distress, hypertension, hypokalemia, negative inotrope, and peripheral edema

Voriconazole - High CSF penetration

 • Variable bioavailability and TDM

 • Hepatotoxicity, photopsia, and photoxic skin reactions, visual hallucinations, rashes/long-term use lead to skin carcinoma, alopecia, and xerosis

Posaconazole - Penetrates most body sites and effective against nonmeningeal coccidioidomycosis

 • Therapeutic drug monitoring advised, low/variable CSF penetration

 • Gastrointestinal distress, hypokalemia, hypertension, peripheral edema

Isavuconazole - Efficacious against primary coccidioidomycosis, prolonged half-life, and tolerable

 • Limited clinical data against meningeal coccidioidomycosis

 • Gastrointestinal distress and hypokalemia

Amphotericin B - Intrathecal route

 • Highly toxic

 • Nephrotoxicity, hepatotoxicity, hypokalemia, phlebitis, fever, chills, dyspnea, chest/back pain



#Coccidioidomycosis #coccidioides #valleyfever #management #treatment #antifungals #comparison #table #pharmacology
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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