Fluconazole resistant strains (C. glabrata, C. krusei)
Caspofungin 70 mg iv 1 dose, then 50 mg iv q24h
Micafungin 100-150 mg iv q24h
Amphotericin B deoxycholate 0.5-1 mg/kg iv q24h
Liposomal amphotericin B 3-5 mg/kg iv q24h
중추신경계 감염
Liposomal amphotericin B 3-5 mg/kg iv q24h ± Flucytosine 25 mg/kg po q6h, 수 주 → Fluconazole 400-800 mg iv/po q24h(모든 증상, 징후, CSF 이상, 방사선학적 이상소견이 소실될 때까지)
intraventricular devices 제거
Liposomal amphotericin B에 tolerable하지 않은 경우 → Fluconazole 400–800 mg iv/po q24h
안구내염(endophthalmitis)
Amphotericin B deoxycholate 0.7-1 mg/kg iv q24h + Flucytosine 25 mg/kg po q6h; Fluconazole 6-12 mg/kg iv/po q24h
안과 협진 필요: partial vitrectomy, intravitreal antifungal therapy with Amphotericin B deoxycholate
Liposomal amphotericin B 3-5 mg/kg iv q24h
Voriconazole 6 mg/kg iv q12h 2 doses, then 3-4 mg/kg iv q12h
요로감염
Fluconazole 200-400 mg iv/po q24h
Flucytosine 25 mg/kg po q6h
Amphotericin B deoxycholate 0.3-1 mg/kg iv q24h
Fluconazole-resistant Candida species
Liposomal amphotericin B 3-5 mg/kg iv q24h
Caspofungin 50 mg iv q24h
Anidulafungin 100 mg iv q24h
Micafungin 100 mg iv q24h
백선감염(Tinea infection)
피부 - 백선감염에서 자세히 살펴보겠습니다.
참조 "피부 - 백선감염" 참조
참고자료
[칸디다증(Candidiasis)]
대한감염학회. 감염학 개정판(2014). P925-940
Fisher JF, Sobel JD, Kauffman CA, Newman CA. Candida urinary tract infections--treatment. Clin Infect Dis 2011;52 Suppl 6:S457-466.
Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016;62(4):e1-5
Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48(5):503–35.
Pappas PG, Rex JH, Sobel JD, et al. Guidelines for treatment of candidiasis. Clin Infect Dis 2004;38(2):161–89.
Bariteau JT, Waryasz GR, McDonnell M, Fischer SA, Hayda RA, Born CT. Fungal osteomyelitis and septic arthritis. J Am Acad Orthop Surg 2014;22(6):390–401.