The IDSA has updated it’s 2004 guidelines on candidiasis (guideline). Among the highlights relevant for hospitalists: Echinocandins (caspofungin, anidulafungin, or micafungin) are recommended for treating clinically severe candidemia, empirically for all candida glabrata, and for those with recent azole use. Fluconazole can be used for clinically stable patients, or for those with confirmed sensitivities. Voriconazole is only advantageous over fluconazole in candida krusei infection, or when there is concomitant mold infection. Treatment should continue for 2 weeks after negative cultures, and intravenous catheters should be removed.
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