Treatment of Candidemia and Invasive Candidiasis

Echinocandin Therapy

All echinocandins (micafungin, caspofungin, anidulafungin) are considered equally effective for candidemia and invasive candidiasis, as stated by the Infectious Diseases Society of America (IDSA) 1, 2
The IDSA recommends any echinocandin as initial therapy for candidemia and invasive candidiasis 2

Treatment should continue for at least 2 weeks after documented clearance of Candida from the bloodstream and resolution of symptoms attributable to candidemia, as recommended by the IDSA 1, 2
For persistent candidemia or complicated infections, longer courses may be necessary, according to the IDSA guidelines 1

Failing to continue therapy for a sufficient duration (at least 2 weeks after blood culture clearance) is a common pitfall, as warned by the IDSA 1
Not removing or replacing central venous catheters when feasible is strongly recommended against by the IDSA, especially for patients with candidemia 1
Premature switching to fluconazole before confirming species identification and susceptibility, especially in critically ill patients, is cautioned against by the IDSA 2
Overlooking the need for ophthalmologic examination to rule out endophthalmitis in patients with candidemia is a mistake to avoid, as advised by the IDSA 2