Fungal Infections

Author: William G. Powderly, MD (More Info)
Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
Last Reviewed: 6/18/19 (What's New)

Supporting Assets

Table 1 | Table 2 | Table 3 | Table 4 | Table 5 | Table 6

Table 1. Treatment of Candidiasis in Patients With HIV^{[CDC OI]}

First-Choice Treatment	Alternative Options
Oropharyngeal candidiasis
Fluconazole 100 mg PO daily (7-14 days)	Clotrimazole troches 10 mg PO 5 times daily (7-14 days) Miconazole mucoadhesive tablet 50 mg applied to mucosal surface over the canine fossa QD (7-14 days) Itraconazole oral solution 200 mg PO daily (7-14 days) Posaconazole oral suspension 400 mg PO BID for 1 day, then 400 mg daily (7-14 days) Nystatin suspension 400,000-600,000 units 4-5 times daily (4-6 mL 4-5 times daily) or 1-2 lozenges 4-5 times daily (7-14 days)
Esophageal candidiasis
Fluconazole 100-400 mg PO or IV daily (14-21 days) Itraconazole oral solution 200 mg PO daily (14-21 days)	Voriconazole 200 mg PO or IV BID (14-21 days) Isavuconazole (14 days) 200 mg PO as a loading dose, followed by 50 mg PO QD, or 400 mg PO as a loading dose, followed by 100 mg PO QD, or 400 mg PO once weekly Caspofungin 50 mg IV daily (14-21 days) Micafungin 150 mg IV daily (14-21 days) Anidulafungin 100 mg IV for 1 day, then 50 mg IV daily (14-21 days) Amphotericin B deoxycholate 0.6 mg/kg IV daily (14-21 days) Amphotericin B lipid complex 3-4 mg/kg IV daily
Uncomplicated vulvovaginal candidiasis
Fluconazole 150 mg PO, 1 dose Clotrimazole topical, butoconazole topical, miconazole topical, tioconazole topical, or terconazole topical for 3-7 days	Itraconazole oral solution 200 mg PO daily for 3-7 days
Severe or recurrent vulvovaginal candidiasis
Fluconazole 100-200 mg PO QD for ≥ 7 days Topical antifungal for ≥ 7 days

BID, twice daily; GI, gastrointestinal; IV, intravenous; PO, orally; QD, once daily

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