TABLE 6.

Induction therapy doses of flucytosine, fluconazole and amphotericin B adjusted according to estimated glomerular filtration rates for adults.

Antifungal agent	eGFR > 50	eGFR 10–50	eGFR < 10	Haemodialysis
Amphotericin B deoxycholate	1 mg/kg	1 mg/kg	1 mg/kg	1 mg/kg (can administer during dialysis)
Fluconazole	1200 mg daily	600 mg daily	600 mg daily	600 mg daily; dose after dialysis
Flucytosine	25 mg/kg 6 hourly	25 mg/kg 12 hourly	25 mg/kg daily	25 mg/kg daily; dose after dialysis

Source: The Sanford guide to antimicrobial therapy 2019 / editors, David N. Gilbert, M.D., George M. Eliopoulos, M.D., Henry F. Chambers, M.D., Michael S. Saag, M.D., Andrew T. Pavia, M.D. Sperryville, VA, USA: Antimicrobial Therapy, Inc., [2019]

Note: Multiply by 0.85 for women. Children: CrCL 20 mL/min – 40 mL/min: flucytosine 25 mg/kg q12h; 10 mL/min – 20 mL/min: flucytosine 25 mg/kg q24 h; < 10 mL/min: flucytosine 25 mg/kg q24–48h. Glomerular filtration rate (GFR) is a key indicator of renal function. Estimated GFR (eGFR) is a mathematically derived entity based on a patient’s serum creatinine level, age, sex and race. Creatinine clearance (CrCL), an estimate of GFR, can be estimated in adults using the Cockcroft–Gault equation: [[140-age (years)]*weight (kg)] / [0.8136*serum creatinine (µmol/L)].