Fungal endocarditis
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Revision as of 17:37, 11 October 2022 by Aidan (talk | contribs) (Aidan moved page Candidal endocarditis to Fungal endocarditis)
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)
- Antifungal therapy should continue for at least 6 weeks after surgery
- Valve replacement is recommended in essentially all cases of fungal endocarditis
- In case of prosthetic valve, this should be followed by lifelong suppressive therapy
- If the valve is not replaced, step-down to lifelong suppressive therapy following treatment is recommended with fluconazole 400-800 mg PO daily
- Alternative: voriconazole 200–300 mg (3–4 mg/kg) PO bid or posaconazole 300 mg PO daily
