Table 1.
Main antifungal combinations used for difficult to treat Candida infections.
| Disease | Therapy | References (from Guidelines) | References (from Case Reports) |
|---|---|---|---|
| Native prosthetic valve endocarditis | LAMB 3–5 mg/kg/d CAS 70–50 mg/d +/− 5FC 25 mg/kg/4 times/d CAS/MCF 150 mg/AND 200 mg plus surgery |
[1,34] | |
| Mural endocarditis | CAS 70–50 mg/d + VCZ 6mg/kg/d/12 h | [63] | |
| Prosthetic mitral valve endocarditis | FCZ 400 mg/iv + CAS 70–50 mg/d | [64] | |
| Native valve endocarditis | AMBd 4 g total dose + CAS 100–50 mg/d | [65] | |
| Central nervous system | LAMB 3–5 mg/kg/d or FCZ + 5FC 25 mg/kg/4 times/d | [1,34] | |
| Candida meningitis | AMBd/LAMB + 5FC AMBd 0.5–1 mg/kg/d i.v./intrathecal 0.025–0.4 mg + 5FC 30–120 mg/kg/d or FCZ 3–8 mg/kg/d |
[67,68] | |
| Endophthalmitis | AMBd i.v. or intravitreal +/− 5FC | [1,34] | |
| Endophthalmitis | VCZ + CAS | [69] | |
| Endophthalmitis | AMBd intravitreal injection 5–10 µg + systemic ATF | [70,71] | |
| Keratitis | AMB + NAT + VCZ | [72] | |
| Osteomyelitis | AMBd/LAMB + 5FC or 5FC + FCZ/VCZ/CAS | [73,74] | |
| Knee arthritis | CAS 70–50 mg/d + 5FC 2.5 g/12 h | [75] | |
| Lumbar spine infection | CAS + PCZ | [76] | |
| Oropharyngeal candidiasis | FCZ + TBF | [77] | |
| Vulvovaginitis | Topical 17% 5FC cream + 3% AMB cream/d NYS vaginal cream + 5FC |
[1] | [78] |
| Candiduria (fungus ball) | AMB + 5FC | [1] |
AMBd: deoxicholate amphotericin B. LAMB: liposomal amphotericin B. 5FC: flucytosine. CAS: caspofungin. MCF: micafungin. AND: anidulafungin. FCZ: fluconazole. NYS: nystatin. VCZ: voriconazole. PCZ: posaconazole. TBF: terbinafine. NAT: natamycin.