Candida Case

[PharmDstudent]

I think we'd end up blowing our entire pharmacy budget on treating one patient if we did that.

Anyways, somewhat of an update...cultures are now Candida negative, yet Amphotericin remains. They must be suspecting something else at this point.

Aspergillosis?

 

[njac]

Except for CAP.

or HAP or VAP or any P...

 

[PharmDstudent]

or HAP or VAP or any P...

Yup Yup! 😀 Something about lung surfactant... and dapto degradation.

 

[Quiksilver]

Do they still think the something else is fungal? Has he had improvement of Sx? Still on Vanco too? If no improvement why haven't we switched to to micafugin? If kidneys still = the suck, why haven't we gone to micafungin? Its not like your hospital is tight on budgets like mine is!

 

[nikkai]

There are contemporary data indicating that when the trough concentration is maintained above 15 mcg/mL, and another nephrotoxic agent is being employed concurrently, the incidence of acute renal injury is as high as 30%. More recent data have also correlated total daily doses greater than 4,000 mg with nephrotoxicity.

January Supplement to 2009 AJHP - Vanco Guidelines - nice little summary of the evidence.

 

[nikkai]

I think we'd end up blowing our entire pharmacy budget on treating one patient if we did that.

Anyways, somewhat of an update...cultures are now Candida negative, yet Amphotericin remains. They must be suspecting something else at this point.

When were those cx's pulled? mushrooms take forever to grow.

 

[Praziquantel86]

When were those cx's pulled? mushrooms take forever to grow.

I'm actually not sure when they were pulled. Maybe they were waiting for two negatives just to account for growth time?

 

[Priapism321]

January Supplement to 2009 AJHP - Vanco Guidelines - nice little summary of the evidence.

I don't recall it being a supplement.

 

[nikkai]

I don't recall it being a supplement.

You're right. It was in the issue. I was thinking of the post-op N/V recommendations