Fluconazole (Diflucan)¶
Overview¶
| Field | Detail |
|---|---|
| Drug class | Triazole antifungal agent |
| Stock formulation | 200 mg/100 mL IV (2 mg/mL) |
| Reconstituted conc. | N/A (Ready to use) |
| Storage | Room temp; Do not freeze or refrigerate |
Preparation¶
Before you start
Ensure the IV bag contains 2 mg/mL. No dilutions are needed for the stock, but SPT is performed at a 1:10 dilution (0.2 mg/mL) as per the clinical protocol.
Equipment needed¶
- 1 × Fluconazole 2 mg/mL IV bag/vial
- Normal saline (NS) — for dilutions
- 1 mL syringes × 3 (for test doses/dilutions)
- 25 G needles
Step 1 — Prepare the SPT solution (0.2 mg/mL — 1:10)¶
- Draw up 0.1 mL of the stock (2 mg/mL) into a 1 mL syringe.
- Add 0.9 mL of NS. Mix. (This is 0.2 mg/mL — 1:10).
- Label: "Fluconazole SPT 0.2 mg/mL".
Step 2 — Prepare IDT dilutions¶
Prepare in this order, using a fresh syringe for each step.
- IDT 0.002 mg/mL (1:1,000):
- Draw 0.1 mL of stock (2 mg/mL) into a 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.2 mg/mL — 1:10).
- Draw 0.1 mL of this 0.2 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.02 mg/mL — 1:100).
- Draw 0.1 mL of this 0.02 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.002 mg/mL — 1:1,000).
- Label: "Fluconazole IDT 0.002 mg/mL".
Skin prick test (SPT)¶
| Reagent | Concentration |
|---|---|
| Test solution | 1:10 (0.2 mg/mL) |
| Positive control | Histamine 10 mg/mL |
| Negative control | Normal saline |
Interpretation: Wheal ≥3 mm vs negative control = positive.
Intradermal test (IDT)¶
Dilution series¶
| Step | Dilution | Concentration | Preparation |
|---|---|---|---|
| 1 | 1:1,000 | 0.002 mg/mL | 0.1 mL of 0.02 mg/mL + 0.9 mL NS |
Inject: 0.05 mL intradermal. Read at 15–20 minutes. Delayed Reading: If history is suggestive of a delayed reaction, re-read at 24 and 48 hours.