Treatment of Male Yeast Infections

Genital Candidiasis (Balanitis)

• For recurrent genital candidiasis, consider maintenance therapy after initial treatment, and eliminate predisposing factors such as uncontrolled diabetes, antibiotic use, immunosuppression, and poor hygiene 1

Urinary Tract Yeast Infections in Males

Asymptomatic Candiduria

• Most asymptomatic candiduria in males does NOT require treatment unless the patient is neutropenic or undergoing urologic procedures, and removing indwelling catheters and unnecessary antibiotics clears candiduria in approximately 50% of asymptomatic patients 2

Symptomatic Cystitis (Bladder Infection)

• For symptomatic urinary yeast infections, oral fluconazole 200 mg (3 mg/kg) daily for 2 weeks is the treatment of choice for fluconazole-susceptible organisms, and catheter removal is mandatory if feasible 3, 2
• For fluconazole-resistant C. glabrata: Amphotericin B deoxycholate 0.3–0.6 mg/kg daily for 1–7 days OR oral flucytosine 25 mg/kg four times daily for 7–10 days 3, 2

Pyelonephritis (Kidney Infection)

• For yeast pyelonephritis, oral fluconazole 200–400 mg (3–6 mg/kg) daily for 2 weeks is recommended for fluconazole-susceptible organisms, and eliminate urinary tract obstruction by removing or replacing nephrostomy tubes and stents if feasible 3, 2

Patients Undergoing Urologic Procedures

• Prophylactic treatment: Oral fluconazole 400 mg (6 mg/kg) daily OR Amphotericin B deoxycholate 0.3–0.6 mg/kg daily for several days before and after the procedure 3, 2

Critical Pitfalls to Avoid

• Do NOT treat asymptomatic candiduria in immunocompetent males, as this leads to unnecessary antifungal exposure and potential resistance development 2
• Failure to remove catheters significantly reduces treatment success, and catheter removal is equally important as antifungal therapy 2
• Bladder irrigation alone has high relapse rates and should only be used as adjunctive therapy for refractory resistant organisms 2