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13 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).

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