ÎTreatment for neonatal candidiasis > AmB-d is recommended for neonates with disseminated candidiasis. If no urinary tract involvement, LFAmB can be used. Fluconazole is an alternative. Treat for 3 weeks. Echinocandins used with caution, limited to when resistance or toxicity preclude use of fluconazole or AmB-d. IV catheter removal recommended. Nurseries with high rates of invasive candidiasis, consider fluconazole prophylaxis in neonates < 1000 g.
ÎProphylaxis > Post-operative prophylaxis recommended in high risk liver, pancreas, and small bowel transplant recipients, with fluconazole or L-AmB for 7-14 days. Fluconazole recommended for high-risk adult ICU patients if high incidence of invasive candidiasis. With chemotherapy-induced neutropenia, caspofungin, fluconazole or posaconazole recommended during induction chemotherapy for duration of neutropenia. For stem cell transplant recipients with neutropenia, fluconazole, micafungin or posaconazole, recommended during the period of risk for neutropenia.
ÎDrug Monitoring > Therapeutic levels for itraconazole and voriconazole should be obtained if the course for deep seated or refractory candidiasis will be prolonged.
