Vascular catheter removal
1st line: IV Echinocandins
Caspofungin 70mg IV day 1, 50mg IV Qdaily x 14 days following the last positive blood culture
Anidulafungin 200mg IV day 1, 100mg IV Qdaily x 14 days following the last positive blood culture
Micafungin 100mg IV Qdaily x 15 days
Step down therapy: as early as 5 days, can step down to oral if blood stream is clear and patient can tolerate oral regime
2nd line:
Fluconazole 800mg IV loading dose, 400mg (6mg/kg) IV Qdaily for 14 days following first negative blood culture
Voriconazole 400mg (6mg/kg) IV Q12 hours x 2 doses (loading dose), 200mg (3mg/kg) IV Q12 x 14 days following first negative blood culture (maintenance dose)
Alternative:
Amphotericin B is acceptable but carries a higher toxicity and side-effect profile
1mg/kg/day IV x 14 days following first negative blood culture
Caspofungin 70mg IV day 1, 50mg IV Qdaily x 14 days following the last positive blood culture
Anidulafungin 200mg IV day 1, 100mg IV Qdaily x 14 days following the last positive blood culture
Micafungin 100mg IV Qdaily x 15 days
Step down therapy: as early as 5 days, can step down to oral if blood stream is clear and patient can tolerate oral regime
Fluconazole 800mg IV loading dose, 400mg (6mg/kg) IV Qdaily for 14 days following first negative blood culture
Voriconazole 400mg (6mg/kg) IV Q12 hours x 2 doses (loading dose), 200mg (3mg/kg) IV Q12 x 14 days following first negative blood culture (maintenance dose)
Amphotericin B is acceptable but carries a higher toxicity and side-effect profile
1mg/kg/day IV x 14 days following first negative blood culture
Invasive candidiasis
Otomycosis
Onychomycosis
Dermatophytosis
Candidiasis
Candida dermatitis
Tinea
Sporotrichosis