From the Guidelines
The treatment for urine hyphae yeast in urinalysis (UA) indicating a fungal infection typically involves antifungal medications, with fluconazole being the first-line treatment, usually prescribed at 200mg on the first day followed by 100-200mg daily for 7-14 days for uncomplicated infections. According to the most recent and highest quality study available 1, fluconazole is the drug of choice for treating Candida UTI, as it achieves high concentrations in the urine and is effective in eradicating candiduria. Some key points to consider in the treatment of fungal urinary tract infections include:
- Elimination of predisposing factors, such as indwelling bladder catheters, is recommended whenever feasible 1
- Treatment with antifungal agents is not recommended unless the patient belongs to a group at high risk for dissemination, such as neutropenic patients, very low-birth-weight infants, or patients who will undergo urologic manipulation 1
- For cystitis due to fluconazole-susceptible Candida species, oral fluconazole at a dosage of 200 mg (3 mg/kg) daily for 2 weeks is recommended 1
- For more severe or resistant infections, alternatives include itraconazole or amphotericin B for systemic infections 1
- Patients should increase fluid intake to help flush out the infection and follow up with repeat urinalysis after completing treatment to ensure resolution
- These infections most commonly involve Candida species, particularly in patients with diabetes, immunosuppression, or those who have recently used antibiotics or catheters
- Treatment duration may be extended in complicated cases or immunocompromised patients, and recurrent infections may require prophylactic therapy and investigation of underlying conditions contributing to susceptibility.
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 urine hyphae yeast in a urinalysis (UA) indicating a fungal infection is fluconazole with a daily dose of 50 to 200 mg.
- The dosage may vary based on the patient's response to therapy and the severity of the infection.
- Treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided 2.
From the Research
Urine Hyphae Yeast in UA
- The presence of hyphae yeast in a urinalysis (UA) indicates a fungal infection, specifically candiduria 3, 4, 5, 6, 7.
- Candiduria can be caused by various factors, including diabetes mellitus, indwelling urinary catheters, use of broad-spectrum antibiotics, urinary obstruction, and admission to intensive care units 3, 5.
Treatment Options
- The treatment of choice for symptomatic candiduria is fluconazole, which achieves high urinary levels 3, 4, 5, 7.
- Amphotericin B deoxycholate is an alternative antifungal agent if fluconazole cannot be used due to resistance, allergy, or failure 3, 5, 7.
- Other azole antifungals and echinocandins are not recommended for the treatment of urinary tract infections because they do not reach sufficient urine levels 3, 4, 7.
Management
- Removing predisposing factors, such as indwelling catheters and antibiotics, can clear candiduria in almost 50% of asymptomatic patients 4, 5.
- Treatment is recommended only when funguria is symptomatic or in cases of fungal colonization when host factors increase the risk of fungemia 3, 5, 7.
- The detection and identification of fungi in urine samples play an essential role in the diagnosis of fungal urinary tract infections 6.