From the FDA Drug Label
The efficacy of oral voriconazole 200 mg twice daily compared to oral fluconazole 200 mg once daily in the primary treatment of EC was demonstrated in Study 150-305, a double-blind, double-dummy study in immunocompromised patients with endoscopically-proven EC.
Voriconazole and fluconazole (200 mg once daily) showed comparable efficacy rates against EC, as presented in Table 16.
Microbiologic success rates by Candida species are presented in Table 17
The treatment for yeast infection in sputum, especially in immunocompromised patients, is voriconazole or fluconazole.
- Voriconazole has been shown to be effective against Candida species, including C. albicans, C. glabrata, and C. krusei.
- Fluconazole is also effective against Candida species, and has been compared to voriconazole in clinical studies. The choice of treatment should be based on the specific Candida species isolated and the patient's clinical condition 1.
From the Research
Treatment for yeast infections in sputum, particularly in immunocompromised patients, typically involves systemic antifungal medications, with fluconazole often being the first-line treatment, as supported by 2. The choice of antifungal medication depends on the severity of the infection, the specific type of yeast, and the patient's underlying health conditions.
- For more severe infections or fluconazole-resistant strains, alternatives include voriconazole (6mg/kg twice daily on day one, then 4mg/kg twice daily) or an echinocandin such as caspofungin (70mg loading dose, then 50mg daily), as discussed in 3.
- Amphotericin B (0.5-1.0 mg/kg/day) may be used for severe infections or when other antifungals fail, as mentioned in 4.
- Treatment duration should be individualized based on clinical improvement and follow-up cultures, with immunocompromised patients often requiring longer treatment courses and may need prophylactic therapy to prevent recurrence, as highlighted in 5.
- Additionally, addressing the underlying cause of immunosuppression when possible is crucial for long-term management, as emphasized in 2.
- These antifungals work by disrupting fungal cell membrane formation or inhibiting essential enzymes needed for fungal cell wall synthesis, effectively eliminating the yeast infection while causing minimal harm to human cells, as explained in 6. It's essential to note that the most recent and highest quality study, 5, provides valuable insights into the antifungal susceptibility profiles of uncommon yeast species, which can inform treatment decisions in clinical practice.