Candida infection candidemia, treatment

Candidemia For the treatment of candidemia in nonneutropenic patients and the following Candida infections disseminated infections in skin and infections in abdomen, kidney, bladder wall, and wounds. 

Systemic Candida infections For the treatment of candidemia and disseminated Candida infections, daily doses of 6 to 12 mg/kg/day have been used. 

Administer caspofungin by slow intravenous (IV) infusion over approximately 1 hour. Candidemia and other Candida infections Administer a single 70 mg loading dose on day 1, followed by 50 mg/day thereafter. The patient s clinical and microbiological response should dictate duration of treatment. In general, continue antifungal therapy for at least 14 days after the last positive culture. 

Caspofungin is indicated in the treatment of invasive aspergillosis in patients refractory to, or intolerant of, other antifungal therapies empirical treatment for presumed fungal infections in febrile, neutropenic patients treatment of esophageal candidiasis treatment of candidemia and the following Candida infections intra-abdominal abscesses, peritonitis, and pleural space infections. 

Fluconazole is very effective in the treatment of infections with most Candida spp. Thrush in the end-stage AIDS patient, often refractory to nystatin, clotrimazole, and ketoconazole, can usually be suppressed with oral fluconazole. AIDS patients with esophageal candidiasis also usually respond to fluconazole. A single 150-mg dose has been shown to be effective treatment for vaginal candidiasis. A 3-day course of oral fluconazole is effective treatment for Candida urinary tract infection and is more convenient than amphotericin B bladder irrigation. Preliminary findings suggest that Candida endophthalmitis can be successfully treated with fluconazole. Stable nonneutropenic patients with candidemia can be adequately treated with fluconazole, but unstable, immunosuppressed patients should initially receive... 

Most clinicians recommend amphotericin B in total dosages of 0.5-1 g administered over approximately 1 to 2 weeks in patients with Candida endophthalmitis and in all neutropenic patients with candidemia. " Longer courses of therapy may be needed in some patients. Observational studies suggest that fluconazole and amphotericin B are similarly effective for the treatment of C. albicans bloodstream infections in the neutropenic patient controlled data, however. 

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