Spectrum: Local Antimicrobial Stewardship, for Alberta Children's Hospital

Fluconazole

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

IV-$15/d PO-$3/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

Neonatal

PO Mild/Moderate

3-6 mg/kg/DAY given as a single daily dose

PO Severe

Up to 12 mg/kg/DAY given as a single daily dose for serious infections and candidemia

Other

Daily dose of fluconazole is the same for oral and IV administration unless otherwise specified.

General Information

Common Usage

Common Usage

  • Candida infections both mucocutaneous and invasive - i.e. Candidemia

  • Cryptococcus and Coccidioides infections

  • Antifungal prophylaxis in immunocompromised

Drug Monitoring

Drug Monitoring

Consider QTc monitoring if concomitant drugs affecting the interval or elevated baseline measurement

Adverse Effects

Adverse Effects

  • QTc prolongation

  • Hepatic enzyme abnormalities

  • Rash

  • GI upset

Major Interactions

Major Interactions

Many via CYP450 - suggest review interactions with pharmacist.

Risk when combining with other QTc prolonging medications

Pharmacology

Pharmacology

Antimicrobial class: Triazole antifungal

Average serum half life:

  • Premature neonates: 47-73.6 hours.

  • Pediatrics (9 months to 15 years): oral 19.5-25 hours

  • 5- 15 years: IV 15-18 hours

  • Adults: Normal renal function: ~30 hours

Route of Elimination: 80% unchanged in urine; 11% metabolites in urine.