Table 3.

International Consensus Conference: general recommendations for management of severe candidal infectionsa

Type of candidal infectionRecommendationb (no. of votes/no. of investigators voting) for use of:
FLUAmBcAmB lipidFLU + AmBcAmB + 5-FCFLU + 5-FCITRA
Candidemia
 Nonneutropenic
  Stable,C. krusei unlikely, no prior FLU therapy20/20
  Stable, received FLU for >2 days3/2010/207/20
  Unstable,C. krusei unlikely, no prior FLU therapy5/204/202/205/204/20
 Neutropenic
  Stable, uncomplicated candidemia, no prior triazole therapy, no sites of hematogenously seeded infection or other forms of deep candidal infection17/203/20
  Stable, non-albicans species identified, or positive blood culture in patient receiving azole therapy5/1813/18
   C. glabrata
   C. krusei 18/18
  Unstable or evidence of deep-organ candidal infection2/201/202/204/2010/201/20
 After solid-organ transplant
  Stable, no prior FLU therapy18/18
  Stable, prior FLU therapy18/18
  Unstable7/184/182/181/184/18
Candiduria
 Non-kruseicystitis19/201/20d
 Presumed upper urinary tract infection, non-krusei Candidaspecies16/181/18e 1/18
Candida peritonitis11/181/184/18f 2/18
Chronic disseminated candidiasis (formerly hepatosplenic), patient no longer neutropenic11/181/184/182/18
Candida endophthalmitis
 Uncomplicated (lesions not advancing rapidly, relatively small, not localized in area of macula)11/181/186/18
 Enlarging lesion or threatening macula18/18
  • a Adapted from reference74 with permission of the publisher.

  • b FLU, fluconazole; AmB, amphotericin B; ITRA, itraconazole.

  • c Standard formulation.

  • d Bladder irrigation.

  • e Intravenous.

  • f AmB initially, followed by FLU.