Sporotrichosis medical therapy: Difference between revisions

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|Osteoarticular
|Osteoarticular
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* Itraconazole 200 mg PO bid
* [[Itraconazole]] 200 mg PO bid
|
|
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>OR</u>'''  
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>OR</u>'''  
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd until symptom resolution
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd until symptom resolution
|For a total of 12 months, switch to itraconazole after resolution/end of treatment.
|For a total of 12 months, switch to [[Itraconazole]] after resolution/end of treatment.
|-
|-
|Pulmonary
|Pulmonary
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|
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid
* [[Itraconazole]] 200 mg PO bid
|
|
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid upon symptom resolution
* [[Itraconazole]] 200 mg PO bid upon symptom resolution
|Treat less sever cases with a 12 month regimen of itraconazole.
|Treat less sever cases with a 12 month regimen of [[Itraconazole]].
|-
|-
|Meningeal
|Meningeal
|
|
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid
* [[Itraconazole]] 200 mg PO bid
|
|
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid upon symptom resolution
* [[Itraconazole]] 200 mg PO bid upon symptom resolution
|Precise length of amphotericin B treatment varies. Suppressive treatment with itraconazole is necessary.  
|Precise length of amphotericin B treatment varies. Suppressive treatment with [[Itraconazole]] is necessary.  
|-
|-
|Dissimated
|Dissimated
|
|
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Limposomal amphotericin B 3-5 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid.
* [[Itraconazole]] 200 mg PO bid.
|
|
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd '''<u>THEN</u>'''  
* Itraconazole 200 mg PO bid upon symptom resolution  
* [[Itraconazole]] 200 mg PO bid upon symptom resolution  
|Continue amphotericin B treatment until patient shows marked improvement for a minimum of 12 months. Suppressive treatment with itraconazole is necessary.
|Continue amphotericin B treatment until patient shows marked improvement for a minimum of 12 months. Suppressive treatment with [[Itraconazole]] is necessary.
|-
|-
|Sporotrichosis in pregnant women
|Sporotrichosis in pregnant women
Line 67: Line 67:
|Sporotrichosis in Children
|Sporotrichosis in Children
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|
* Itraconazole 6-10 mg PO qd to a max of 400 mg PO qd for mild cases '''<u>OR</u>'''
* [[Itraconazole]] 6-10 mg PO qd to a max of 400 mg PO qd for mild cases '''<u>OR</u>'''
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd for severe cases
* Deoxycholate amphotericin B 0.7-1 mg/kg PO qd for severe cases
|
|
* SSKI increasing doses equivalent to half the adult dose, continuing treatment for 2-4 weeks after resolution of symptoms.
* [[Potassium iodide|SSKI]] increasing doses equivalent to half the adult dose, continuing treatment for 2-4 weeks after resolution of symptoms.
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|
|}
|}

Revision as of 14:32, 13 January 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]

Treatment

Form Primary Line of Treatment Alternative Treatment Remarks/Other
Uncomplicated cutaneous Continue treatment for 2-4 weeks after lesions resolve.
Osteoarticular
  • Limposomal amphotericin B 3-5 mg/kg PO qd OR
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd until symptom resolution
For a total of 12 months, switch to Itraconazole after resolution/end of treatment.
Pulmonary
  • Limposomal amphotericin B 3-5 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid upon symptom resolution
Treat less sever cases with a 12 month regimen of Itraconazole.
Meningeal
  • Limposomal amphotericin B 3-5 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid upon symptom resolution
Precise length of amphotericin B treatment varies. Suppressive treatment with Itraconazole is necessary.
Dissimated
  • Limposomal amphotericin B 3-5 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid.
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd THEN
  • Itraconazole 200 mg PO bid upon symptom resolution
Continue amphotericin B treatment until patient shows marked improvement for a minimum of 12 months. Suppressive treatment with Itraconazole is necessary.
Sporotrichosis in pregnant women
  • Treat with limposomal amphotericin B 3-5 mg/kg PO qd OR
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd only for severe cases of sporotrichosis OR
  • In cases of uncomplicated cutaneous, treat with only hyperthermia.
It is preferable to defer treatment in uncomplicated cases.
Sporotrichosis in Children
  • Itraconazole 6-10 mg PO qd to a max of 400 mg PO qd for mild cases OR
  • Deoxycholate amphotericin B 0.7-1 mg/kg PO qd for severe cases
  • SSKI increasing doses equivalent to half the adult dose, continuing treatment for 2-4 weeks after resolution of symptoms.

[1]

References

  1. Kauffman CA, Bustamante B, Chapman SW, Pappas PG, Infectious Diseases Society of America (2007). "Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America". Clin Infect Dis. 45 (10): 1255–65. doi:10.1086/522765. PMID 17968818.