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Author: Admin | 2025-04-28
Least 2 weeks after candidemia clearedInfected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removedComments:Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate.Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill.Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitisRecommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VADUsual Adult Dose for Systemic CandidiasisDoses up to 400 mg/day have been used.Comments:Optimal therapeutic dose and therapy duration have not been established.Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumoniaIDSA Recommendations:Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a dayDuration of therapy:Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolveNeutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolveChronic disseminated candidiasis in stable patients: 400 mg IV or orally once a dayDuration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppressionCandida osteoarticular infection: 400 mg IV or orally once a dayDuration of therapy:Osteomyelitis: 6 to 12 monthsSeptic arthritis: At least 6 weeksCNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a dayDuration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolveCandida cardiovascular system infection: 400 to 800 mg IV or orally once a dayDuration of therapy:Endocarditis: Lifelong suppressive therapy may be indicated.Pericarditis or myocarditis: Often several monthsSuppurative thrombophlebitis: At least 2 weeks after candidemia clearedInfected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removedComments:Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate.Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and
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