Managing Candida Infection Algorithms Candida Urinary Tract Infections
Symptomatic candiduria?
NO
High Risk group?
NO
No treatment (image urinary
tract if indicated and eliminate predisposing factors)
YES Urologic
manipulation planned
Neutropenic, low birth weight infant
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
Suspected disseminated candidiasis
Cystitis
Pyelonephritis Fungus (non-ne
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) 2
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
