APPROPRIATE DURATION OF INTRAVENOUS TREATMENT OF CANDIDEMIA AND TIMING OF STEP DOWN TO ORAL THERAPY IN NON-NEUTROPENIC PATIENTS

• Main Authors: Rita Wilson Dib, Ray Hachem, Anne-Marie P Chaftari, Issam I Raad
• Format: Article
• Language: English
• Published: PAGEPress Publications 2018-05-01
• Series: Mediterranean Journal of Hematology and Infectious Diseases
• Subjects: Candidemia, non-nuetropenic patients, intravenous treatment
• Online Access: https://www.mjhid.org/index.php/mjhid/article/view/3345

In this review we have analyzed the available literature pertaining to the total duration of intravenous (IV) therapy and the appropriate timing of step down to oral therapy in the management of candidemia. Overview of the guidelines and literature seem to indicate that a minimum of 14 days of antifungal therapy is required in the treatment of candidemia without deep seated infection. However, this was never based on evidence. Furthermore, step down to oral therapy seems to be dependent on the clinical stability criteria of the patient with candidemia after 4 to 7 days of IV therapy.  Further studies are required to evaluate the appropriate total duration of IV therapy, appropriate timing of step down to oral therapy and to validate the clinical criteria that would allow the switch to happen.