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Î A less preferred alternative for those who cannot tolerate oral therapy
is AmB deoxycholate, 0.3-0.7 mg/kg daily (S/M).
Î Consider de-escalating to oral therapy with fluconazole 200-400 mg
(3-6 mg/kg) daily once the patient is able to tolerate oral intake (S/M).
Î For fluconazole-refractory disease, itraconazole solution, 200 mg
daily, OR voriconazole, 200 mg (3 mg/kg) twice daily either IV or oral,
for 14-21 days is recommended (S/H).
Î Alternatives for fluconazole-refractory disease include an
echinocandin (micafungin, 150 mg daily, caspofungin, 70 mg loading
dose, then 50 mg daily, or anidulafungin, 200 mg daily) for 14-21 days,
OR AmB deoxycholate, 0.3-0.7 mg/kg daily, for 21 days (S/H).
Î Posaconazole suspension, 400 mg twice daily, or extended-release
tablets, 300 mg once daily, could be considered for fluconazole-
refractory disease (W/L).
Î For patients who have recurrent esophagitis, chronic suppressive
therapy with fluconazole, 100-200 mg 3 times weekly, is
recommended (S/H).
Î For HIV-infected patients, antiretroviral therapy is strongly
recommended to reduce the incidence of recurrent infections (S/H).
