TABLE 3.

International Consensus Conference: general recommendations for management of severe candidal infections^a

Type of candidal infection	Recommendationb (no. of votes/no. of investigators voting) for use of:
	FLU	AmBc	AmB lipid	FLU + AmBc	AmB + 5-FC	FLU + 5-FC	ITRA
Candidemia
Nonneutropenic
Stable, C. krusei unlikely, no prior FLU therapy	20/20
Stable, received FLU for >2 days	3/20	10/20			7/20
Unstable, C. krusei unlikely, no prior FLU therapy	5/20	4/20	2/20	5/20	4/20
Neutropenic
Stable, uncomplicated candidemia, no prior triazole therapy, no sites of hematogenously seeded infection or other forms of deep candidal infection	17/20	3/20
Stable, non-albicans species identified, or positive blood culture in patient receiving azole therapy	5/18	13/18
C. glabrata
C. krusei		18/18
Unstable or evidence of deep-organ candidal infection	2/20	1/20	2/20	4/20	10/20	1/20
After solid-organ transplant
Stable, no prior FLU therapy	18/18
Stable, prior FLU therapy		18/18
Unstable	7/18	4/18	2/18	1/18	4/18
Candiduria
Non-krusei cystitis	19/20	1/20d
Presumed upper urinary tract infection, non-krusei Candida species	16/18	1/18e					1/18
Candida peritonitis	11/18		1/18	4/18f		2/18
Chronic disseminated candidiasis (formerly hepatosplenic), patient no longer neutropenic	11/18		1/18	4/18		2/18
Candida endophthalmitis
Uncomplicated (lesions not advancing rapidly, relatively small, not localized in area of macula)	11/18				1/18	6/18
Enlarging lesion or threatening macula					18/18

^aAdapted from reference 74 with permission of the publisher. 

^bFLU, fluconazole; AmB, amphotericin B; ITRA, itraconazole. 

^cStandard formulation. 

^dBladder irrigation. 

^eIntravenous. 

^fAmB initially, followed by FLU.