Overview of initial therapy for candidaemia
The choice of initial therapy for candidaemia depends on whether the patient is critically ill, the presumed site of primary infection and the patient’s age.
For critically ill patients, use an echinocandin (eg anidulafungin, caspofungin, micafungin), unless the candidaemia originates from the central nervous system. Management of candidaemia with infection involving the central nervous system is beyond the scope of these guidelines – see the Australian and New Zealand Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings for detailed advice.
For noncritically ill patients, an echinocandin is usually used first line, but fluconazole may be considered by an infectious diseases physician or clinical microbiologist for patients who are at lower risk of infection with a fluconazole-resistant Candida species (eg patients not previously exposed to azole antifungals).
Initial regimens for candidaemia are included in this topic for: