From the Guidelines
To treat yeast in urine, fluconazole is the recommended antifungal medication, typically prescribed at a dosage of 200 mg (3 mg/kg) daily for 2 weeks for cystitis due to a fluconazole-susceptible Candida species 1.
Key Considerations
- The treatment approach depends on the severity of the infection and the susceptibility of the Candida species to antifungal agents.
- For fluconazole-resistant organisms, alternative therapies such as AmB-d or flucytosine may be considered 1.
- It is essential to eliminate predisposing factors, such as urinary catheters, to prevent recurrence of candiduria 2.
Treatment Options
- Fluconazole: 200 mg (3 mg/kg) daily for 2 weeks for cystitis due to a fluconazole-susceptible Candida species 1.
- AmB-d: 0.3–0.6 mg/kg daily for 1–7 days or oral flucytosine at a dosage of 25 mg/kg 4 times daily for 7–10 days for fluconazole-resistant organisms 1.
- Bladder irrigation with AmB-d may be considered for patients with refractory fluconazole-resistant organisms, but it is generally not recommended due to the risk of recurrence 1.
Additional Recommendations
- Drink plenty of water to flush out the urinary system.
- Maintain good hygiene by wiping front to back after using the bathroom.
- Wear cotton underwear and avoid douches or scented products in the genital area.
- If symptoms persist after treatment or recur frequently, consult a healthcare provider to rule out underlying conditions requiring different management 2.
From the FDA Drug Label
Urinary tract infections and peritonitis: For the treatment of Candida urinary tract infections and peritonitis, daily doses of 50 to 200 mg have been used in open, noncomparative studies of small numbers of patients. The treatment for yeast in urine is fluconazole with a daily dose of 50 to 200 mg.
- The dosage may vary based on the patient's response to therapy.
- Treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided 3.
From the Research
Treatment Options for Yeast in Urine
- The presence of yeast in urine, also known as candiduria, can be treated with antifungal therapy in symptomatic patients 4, 5, 6.
- Fluconazole is the treatment of choice for symptomatic infections, as it achieves high urinary levels 4, 5, 6.
- The recommended dose of fluconazole for the treatment of symptomatic fungal urinary tract infection is 200-mg loading dose followed by 100 mg/d for at least four days 7.
- Removing predisposing factors, such as indwelling catheters and antibiotics, can clear candiduria in almost 50% of asymptomatic patients 5.
- Amphotericin B deoxycholate is an alternative antifungal agent if fluconazole cannot be used due to resistance, allergy, or failure 4, 6.
Duration of Treatment
- The Infectious Diseases Society of America guidelines recommend 14 days of treatment for Candida spp. urinary tract infections 8.
- However, a recent study found that there was no statistically significant difference in clinical treatment success in patients treated with fluconazole for a median of 14 days vs a median of 7 days for symptomatic Candida spp. UTI 8.
- The study suggests that shorter antifungal durations may be effective for Candida spp. UTI, but further research is needed to confirm this finding 8.
Patient Factors
- The decision to treat candiduria depends on the patient's underlying health status, with treatment recommended for symptomatic patients or those with risk factors for fungemia 4, 6.
- Patients with diabetes mellitus, indwelling urinary catheters, or those taking broad-spectrum antibiotics are at increased risk of developing candiduria 4, 6.
- Neutropenic patients, very low-birth-weight infants, and patients undergoing urologic procedures may also require antifungal therapy for candiduria 4.