How to Treat Candida in ICU Patients

According to the "Journal of Antimicrobial Chemotherapy," candida---or yeast---infections have risen in the last two decades, and have become a problem for intensive care units (ICUs). As a matter of fact, 40 percent to 52 percent of all hospital candida cases occur in the ICU. Several types of candida exist, and treatment varies depending on the type and whether the patient has organ failure.

Instructions

1

Prevent candida infections in the ICU by maintaining good operative techniques, controlling diabetes in patients and using antibiotics conservatively. In addition, the "Journal of Antimicrobial Chemotherapy" suggests changing catheter lines one week after insertion, as this could reduce the incidence of a candida infection by 86 percent. The Journal states that most ICUs do this by procedure. In addition, there may be some benefit in using an antifungal medication such as fluconazole on all ICU patients as a preventative measure. The Journal states that several studies have looked at the efficacy of using this drug for prevention. Overall, incidences of candida were reduced; however, mortality rates didn't improve. Also, long-term effects of the routine use of fluconazole aren't known.

2

Use fluconazole on patients who don't have organ failure. Give the patient 400 mg to 800 mg per day intravenously for the treatment of candida albicans or candida parapsilosis. The Journal states that fluconazole treats 70 percent of patients affected. Some strains of candida, such as candida glabrata---the second most common form of candida in adults in most countries---and candida krusei are immune to fluconazole, so other medications must be used when the patient isn't responsive to fluconazole.

3

Treat other forms of candida as well. To treat candida glabrata, administer echinocandin (Caspofungin) intravenously. For the first dose, give the patient 70 mg. After that, administer 50 mg a day. You could also try LipAmB. Administer three mg to five mg per kilogram of weight per day. In addition to fluconazole, patients with candida parapsilosis can also receive LipAmB. Administer three mg to five mg per kilogram of weight per day.

4

Treat patients with organ failure as you would treat those infected with candida glabrata or candida krusei. See the above step for dosage information. In critically ill patients, the drugs listed in step three prove to be an effective alternative to fluconazole, as there's low toxicity reported and low interaction with other drugs.