Managing Candida Infection Algorithms
Candida Urinary Tract Infections
Symptomatic
candiduria?
NO
YES
High Risk
group?
NO
No treatment
(image urinary
tract if indicated
and eliminate
predisposing
factors)
Suspected
disseminated
candidiasis
Cystitis
Pyelonephritis
Fungus
(non-ne
Manage as
for invasive
candidiasis
Fluconazole,
if resistant:
AmB-d or
flucytosine
Fluconazole;
if resistant:
AmB-d or
flucytosine or
both
Surg
interve
recomm
plu
flucon
YES
Urologic
manipulation
planned
Neutropenic,
low birth
weight infant
Fluconazole
or AmB-d
daily several
days before
and after
procedure
Manage as
for invasive
candidiasis
Consider AmB-d bladder
irrigation for fluconazole
resistant candida
(such as C. glabrata
or C. krusei)
If access to
collecting sy
available, irrig
with AmB-d
suggeste
Medication (Generic/Brand)
Dosing
Fluconazole (Diflucan)
For Cystitis: 200 mg (3 mg/kg) daily x 14 days
For Pyelonephritis: 200-400 mg (3-6 mg/kg) daily x 14 days
For Fungus Balls: Surgical intervention + 200-400 mg
(3-6 mg/kg) daily till symptoms resolve and negative cultures
AmphB deoxycholate (AmB-d)
For Cystitis: 0.3-0.6 mg/kg daily for 1-7 days
For Pyelonephritis, 0.5-0.7 mg/kg daily for 14 days
For Fungus Balls: Surgical intervention + 0.5-0.7 mg/kg daily
till symptoms resolve and negative cultures
Flucytosine (Ancobon)
For Cystitis: 25 mg/kg qid 7-10 days
For Pyelonephritis: 25 mg/kg qid for 14 days
For Fungus Balls: Surgical intervention + 25 mg/kg qid until
symptoms resolve and negative cultures
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