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5.2 ANTIFUNGAL DRUGS

5.2 ANTIFUNGAL DRUGS

The most recent Guidelines for Primary and Secondary Care can be found below:

Antimicrobial Guidelines in Primary Care

Antimicrobial Guidelines for Secondary Care

For further guidance refer to local Consultant Microbiologists or contact your pharmacist.

 
        Treatment of Oral Candidiasis in adults 
        First line: 
                Fluconazole* 50mg (capsules) orally once daily
                Course duration 7 days
        *Fluconazole has clinically significant interactions with other medicines - check these before prescribing
 
        Second line when fluconazole is contraindicated
                   Nystatin suspension 100,000units/mL  dose 4ml every 6 hours
                   Course duration 7 days


        GREEN      Amphotericin lozenges 1mg
 
        RED           Amphotericin
                           Injection liposomal 50mg (on advice of Consultant Microbiologist only)
                           Injection complex 50mg   (on advice of Consultant Microbiologist only)
        GREEN      Fluconazole
                           capsules 50mg, 150mg, 200mg
                           suspension 50mg/5ml,  200mg/5mL
        RED           Fluconazole
                          injection 50mg/25mL
                          infusion 200mg/100mL
        RED           Flucytosine
                          infusion 10mg/mL 250mL (on advice of Consultant Microbiologist only)
        GREEN      Itraconazole 
                           capsules 100mg
                           liquid 50mg/5mL
        GREEN      Ketoconazole tablets 200mg
        GREEN      Miconazole oral gel 24mg/mL
        GREEN      Nystatin suspension 100,000u/mL
        GREEN      Terbinafine tablets 250mg
        AMBER     Voriconazole
                          Tablets 50mg, 200mg  [on advice of microbiologist only, '2 weeks only']
                          Suspension 200mg/5mL [on advice of microbiologist only, '2 weeks only']
        RED           Voriconazole Intravenous infusion 200mg
        RED           Isavuconazole [2nd line use when side effects to voriconazole and use only on advice of Consultant Microbiologist]
                          Capsules 200mg [Cresemba®]
                          Powder for concentrate for solution for infusion [Cresemba®]
        RED           Micafungin intravenous infusion 50mg and 100mg (paediatric use only)
        RED             Anidulafungin intravenous infusion 100mg (adult use) 
        RED           Posaconazole suspension 200mg/5mL
 
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 public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service 
  Email: info.elmmb@nhs.net
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