Case Studies (April 2018)

APRIL 23, 2018
Vangjelis Kristollari, PharmD Candidate; Erin R. Weeda, PharmD; and Craig I. Coleman, PharmD
ANSWERS

Case 1: According to the 2016 Infectious Diseases Society of America guidelines on the management of infections due to Candida, voriconazole is the recommended step-down oral therapy for bloodstream infections due to C. krusei. Although fluconazole is commonly used as step-down therapy for candidemia caused by other species, all C. krusei isolates are resistant to it. Thus, the pharmacist should recommend NK receive 200 mg of oral voriconazole twice daily for 2 weeks instead of fluconazole.

Case 2: Oropharyngeal thrush, also known as oropharyngeal candidiasis, is a common In November 2016, the Advisory Committee on Immunization Practices released a statement recommending that all HIV-infected individuals older than 2 months receive the meningococcal conjugate vaccine. This advice is based on several observational studies showing an increased risk for meningococcal infection among individuals infected with HIV. MK should be offered 2 doses of the MenACWY conjugate vaccine, which protects against serogroups A, C, W, and Y. The doses should be spaced 8 to 12 weeks apart, and MK should receive a booster dose every 5 years thereafter.
 

Mr. Kristollari is a PharmD candidate from the University of Connecticut School of Pharmacy in Storrs, Connecticut. Dr. Weeda is an outcomes research fellow at the University of Connecticut School of Pharmacy in Storrs, Connecticut. Dr. Coleman is a professor at the University of Connecticut School of Pharmacy in Storrs, Connecticut.



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