Question #11
AJ is a 32 year-old male who underwent a deceased donor kidney transplant (DDKT) two months ago. He has not done well after the transplant and is currently being managed in a surgical intensive care unit. At this time he has been febrile for 72 hours and the infectious disease consult service is called in to assist. The patient has been on meropenem to cover for a Gram negative rod isolated from a sputum culture plus he is on linezolid for broad-spectrum coverage of Gram positive bacteria. He now has a urine culture positive for yeast. During rounds the attending physician notes she usually does not treat yeast in the urine, because it typically represents colonization/ contamination rather than infection, however in this case the patient is immunocompromised and she feels it is reasonable to give an antifungal drug. Which of the following would be out of the question for covering for a potential fungal UTI?
A. Fluconazole (Diflucan)
B. Voriconazole (VFEND)
C. Micafungin (Mycamine)
D. Amphotericin B lipid formulation (Abelcet)