Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Non-Neutropenic

Empiric Regimen

Fluconazole 800mg (or 12 mg/kg) IV or oral loading dose, then 400mg (6 mg/kg) IV or orally daily

OR

Caspofungin 70 mg x 1 then 50 mg IV daily
  • If critically ill or at risk for fluconazole-resistant organism

Duration of Therapy

Minimum 14 days after negative blood culture.

Tailor with source and other foci of infection.

Comments

Change to Fluconazole once clinically stable, repeat blood cultures are negative, and susceptibility is established.