Page 10 - Parkview Antimicrobial Stewardship Guidebook_Neat

Alternatives to Restricted Antimicrobials

Alternatives to IV Voriconazole:
Indication: Drug:
Invasive apergillosis Micofungin 100mg daily
Esophageal candidiasis Fluconazole 100mg daily
Micafungin 100mg daily
Candidemia (non-neutropenic) Micafungin 100mg daily
Disseminated Candida (skin, abdomen, kidney Micafungin 100mg daily
bladder wall and wounds)
Fungal prophylaxis ORAL voriconazole
Coccidioidomycosis treatment in HIV patients Ketoconazole tablets 400mg/day
Fluconazole 400 mg/ day
Neutropenic fever (no obvious signs of infection) Micafungin
Neutropenic fever with pulmonary nodules or Think invasive mold infection—keep IV
nodular pulmonary infiltrates voriconazole and page I.D
Neutropenic fever – persistently febrile and Consider alternative antifungal
receiving antifungal prophylaxis

Alternative options to Aminoglycosides:
Indication: Drug:
Complicated UTI/ Pyelonephritis FQ or ceftriaxone monotherapy
Brucellosis Doxycycline + rifampin
Meningitis-Pseudomonas (given intrathecally) Meropenem
Cefepime
Ceftazidime