Version May 2024
| Condition or treatment group | Therapy | ||
| Primary | Alternative | Comments | |
| Asymptomatic candiduria | Therapy is not usually indicated, unless patients are at high risk for dissemination (neutropenic patients, very low birthweight infants [<1500 g], patients undergoing urologic procedures). Neutropenic patients and very low birthweight infants should be treated with similar regimens as patients with candidemia.* Patients undergoing a urologic procedure: oral fluconazole 400 mg or amphotericin B deoxycholate¶ 0.3 to 0.6 mg/kg IV daily for several days before and after the procedure. | N/A | Elimination of predisposing factors is recommended. |
| Cystitis | For fluconazole-susceptible isolates: fluconazole 200 mg orally daily for two weeks | For fluconazole-resistant C. glabrata: amphotericin B deoxycholate¶ 0.3 to 0.6 mg/kg IV daily for 1 to 7 days or flucytosine 25 mg/kg orally four times daily for 7 to 10 days For C. krusei: amphotericin B deoxycholate¶ 0.3 to 0.6 mg/kg IV for 1 to 7 days | Indwelling bladder catheters should be removed, if feasible. Amphotericin B deoxycholate bladder irrigation 50 mg/L sterile water daily for 5 days can be used for patients with fluconazole-resistant organisms, such as C. krusei and C. glabrata. |
| Pyelonephritis | Fluconazole 200 to 400 mg orally daily for two weeks | For fluconazole-resistant C. glabrata: amphotericin B deoxycholate¶ 0.3 to 0.6 mg/kg IV daily with or without flucytosine 25 mg/kg orally four times daily for 1 to 7 days or flucytosine alone for two weeks For C. krusei: amphotericin B deoxycholate¶ 0.3 to 0.6 mg/kg IV for 1 to 7 days | Elimination of urinary tract obstruction is strongly recommended. For patients with nephrostomy tubes or stents, consider removal or replacement, if feasible. |
| Urinary fungus balls | Surgical removal is strongly recommended. Antifungal therapy should be given according to the recommendations for pyelonephritis; therapy should be continued until a procedure to remove the fungus ball has been performed and symptoms have resolved. | N/A | If nephrostomy tubes are present, irrigate with amphotericin B deoxycholate 25 to 50 mg in 200 to 500 mL sterile water as an adjunct to systemic antifungal therapy. |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
