Fungal endocarditis: Difference between revisions
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Revision as of 00:11, 23 February 2020
Management
- Initial treatment with liposomal amphotericin B 3-5 mg/kg IV daily, ± flucytosine 25 mg/kg PO qid
- Alternative: high-dose echinocandin (caspofungin 150 mg IV daily, micafungin 150 mg IV daily, or anidulafungin 200 mg IV daily)
- Step-down suppressive therapy following treatment is lifelong fluconazole 400-800 mg PO daily
- Alternative: voriconazole 200–300 mg (3–4 mg/kg) PO bid or posaconazole 300 mg PO daily
- Valve replacement is recommended in essentially all cases of fungal endocarditis
- Antifungal therapy should continue for at least 6 weeks after surgery
- In case of prosthetic valve, this should be followed by lifelong suppressive therapy
