Candida in blood is clinically significant: start appropriate antifungal therapy, document clearance, address intravascular/abdominal sources and determine duration from bloodstream clearance.
Treat Candida recovered from blood as clinically significant. Obtain repeat blood cultures daily or every other day until clearance and assess for an intravascular catheter, abdominal source, prosthetic material or metastatic focus when suggested by symptoms/persistent positivity.
In a critically ill adult, an echinocandin is preferred initial therapy. Fluconazole is an alternative only in selected clinically stable patients unlikely to harbor an azole-resistant species. Obtain species identification and susceptibility information when available.
Remove a central venous catheter early when it is the presumed source and removal is safe; individualize in neutropenia/uncertain source. Persistent candidemia should trigger renewed imaging/source search and evaluation for deep or metastatic infection.
Current global candidiasis guidance.
Established candidemia initial therapy, clearance, catheter and duration recommendations.
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