Treatment of Candida tropicalis UTI

Initial Assessment and Management Approach

The Infectious Diseases Society of America recommends that asymptomatic candiduria does not require treatment unless the patient is neutropenic, a very low-birth-weight infant, or undergoing urologic procedures 1
Removing or replacing urinary catheters if present can resolve candiduria in approximately 50% of cases, as this eliminates predisposing factors 2

For symptomatic cystitis, the primary therapy is fluconazole 200 mg (3 mg/kg) orally daily for 2 weeks, as recommended by the Infectious Diseases Society of America, with demonstrated 82% efficacy 2, 1
For pyelonephritis, the primary therapy is fluconazole 200-400 mg (3-6 mg/kg) orally daily for 2 weeks, with the higher dose range (400 mg) appropriate for more severe upper tract infections 1, 3

The Infectious Diseases Society of America recommends that imaging is indicated if treatment failure occurs despite appropriate therapy, or if there is suspicion of fungus balls, hydronephrosis, abscesses, or structural abnormalities 2
Fungus balls require surgical intervention in addition to antifungal therapy, as recommended by the Infectious Diseases Society of America 1, 3
The duration of therapy should continue until symptoms resolve and urine cultures no longer yield Candida species, with a standard duration of 2 weeks for uncomplicated cases 2, 1, 3

Amphotericin B deoxycholate 1 mg/kg daily is recommended for disseminated candidiasis in neonates, as suggested by the Infectious Diseases Society of America 4
Fluconazole 12 mg/kg IV or oral daily is a reasonable alternative for neonates if not on fluconazole prophylaxis, according to the Infectious Diseases Society of America 4