From the Guidelines
The treatment for budding yeast in urine should be guided by the patient's risk factors and symptoms, with antifungal agents only recommended for high-risk patients, such as neutropenic patients, very low-birth-weight infants, and patients who will undergo urologic manipulation, as stated in the 2016 update by the Infectious Diseases Society of America 1.
Treatment Approach
When treatment is necessary, the following approaches can be considered:
- For fluconazole-susceptible Candida species, oral fluconazole at a dosage of 200 mg (3 mg/kg) daily for 2 weeks is recommended, as per the 2009 guidelines 1.
- For patients undergoing urologic procedures, treatment with oral fluconazole, 400 mg (6 mg/kg) daily, or AmB deoxycholate, 0.3–0.6 mg/kg daily, for several days before and after the procedure is recommended 1.
Key Considerations
- Elimination of predisposing factors, such as indwelling bladder catheters, is crucial whenever feasible 1.
- Treatment with antifungal agents is not recommended unless the patient belongs to a high-risk group, as the risk of adverse effects and the development of resistance should be weighed against the potential benefits 1.
Patient Management
- Patients should be educated on the importance of completing the full course of medication, even if symptoms improve quickly.
- Increasing fluid intake and avoiding irritants like alcohol, caffeine, and spicy foods during treatment can help alleviate symptoms.
- Personal hygiene measures, such as wiping front to back after using the toilet, wearing cotton underwear, and avoiding tight-fitting clothes, can prevent recurrence.
From the FDA Drug Label
Fluconazole tablets were also effective for the treatment of Candida urinary tract infections
- Treatment for budding yeast in urine: Fluconazole (PO) is effective for the treatment of Candida urinary tract infections, which includes budding yeast in urine.
- Key points:
- Fluconazole tablets are indicated for the treatment of various fungal infections, including Candida urinary tract infections.
- The treatment may be instituted before the results of the cultures and other laboratory studies are known, but should be adjusted accordingly once the results become available. 2
From the Research
Treatment for Budding Yeast in Urine
The treatment for budding yeast in urine, also known as candiduria, depends on the presence of symptoms and the patient's risk factors.
- Asymptomatic patients do not require antifungal therapy, except for neutropenic patients, very low-birth-weight infants, and patients undergoing urologic procedures 3, 4.
- For symptomatic infections, fluconazole is the treatment of choice, as it achieves high urinary levels 3, 4.
- Alternative antifungal agents, such as amphotericin B, can be used if fluconazole cannot be used due to resistance, allergy, or failure 3, 4.
- Removing predisposing factors, such as indwelling catheters and antibiotics, can clear candiduria in almost 50% of asymptomatic patients 4.
- Invasive infections, such as fungus balls or renal abscesses, may require percutaneous and endoscopic interventions 5.
Antifungal Agents
- Fluconazole is the most commonly recommended antifungal agent for the treatment of candiduria, due to its high urinary concentrations and effectiveness 3, 4.
- Amphotericin B is an alternative antifungal agent that can be used if fluconazole cannot be used 3, 4.
- Echinocandins and newer azole agents are not recommended for the treatment of urinary tract infections, as they do not achieve adequate urine concentrations 3, 4.
- However, echinocandins have been shown to be effective in the treatment of invasive candidiasis, and may be considered as a first-line agent in certain cases 6.