Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Esophageal candidiasis medical therapy
Introduction
Overview
Overview
Esophageal candidiasis is almost always treated with systemic antifungals (either parentral or oral). A trial of antifungal therapy is done before performing endoscopy in HIV patients with esophagitis.
Medical therapy
Medical therapy
- Esophageal candidiasis is almost always treated with systemic antifungals (either parentral or oral).[1]
- A trial of antifungal therapy is done before performing endoscopy in HIV patients with esophagitis (because candida esophagitis is the most common cause of infectious esophagitis). If no improvement within 5-7 days, then endoscopy is indicated.
First line antifungal therapy:
- Oral fluconazole: 200-400 mg for 14-21 days
- IV fluconazole: 400 mg daily (6mg/kg/day)
- Amphotericin B deoxycholate (AmB-d): 0.3-0.7 mg/day
In fluconazole refractory patients:
- Itraconazole: 200 mg daily
- Voriconazole: 200 mg twice daily for 14-21 days
- Micafungin: 150 mg daily
- Caspofungin: 50 mg daily
- Anidu-lafungin: 200 mg daily
- AmB-d: 0.3 – 0.7 mg/kg daily
Prophylactic (suppressive) therapy:
- Fluconazole 100-200 mg 3 times/ week
HIV patients:
- Highly active antiretroviral theapy (HAART) decreases recurrence of candida esophagitis.
Supportive therapy in patients with severe odynophagia:
Nutritional support:
- IV fluids or total parentral nutrition.
- Gastric tube feeding
Symptomatic treatment:
- Analgesics in the form of NSAIDs or morphia.
- Calcium channel blockers to avoid spasms in response to the pain.
References
References
- ↑ Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD (2016). “Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America”. Clin. Infect. Dis. 62 (4): e1–50. doi:10.1093/cid/civ933. PMC 4725385. PMID 26679628.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]