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 recommended dose of Diflucan (fluconazole) for a patient with a fungal urinary tract infection (UTI) and a Foley catheter is 50 to 200 mg daily 1.
From the Research
For a patient with a fungal urinary tract infection (UTI) and a Foley catheter, the recommended dose of Diflucan (fluconazole) is typically 200 mg on the first day, followed by 100-200 mg daily for 7-14 days. The duration of treatment depends on the severity of the infection and the patient's clinical response. For complicated fungal UTIs associated with indwelling catheters, a 14-day course is often necessary 2. The medication can be administered orally or intravenously if the patient cannot take oral medications. Catheter removal or replacement should be considered when possible, as the presence of the catheter can serve as a nidus for persistent infection. Some key points to consider in the treatment of fungal UTIs include:
- Fluconazole works by inhibiting fungal cytochrome P450 enzyme 14α-demethylase, which disrupts ergosterol synthesis in the fungal cell membrane, leading to increased permeability and cell death.
- Renal dose adjustment is necessary for patients with impaired kidney function, typically reducing the dose by 50% if creatinine clearance is less than 50 mL/min.
- Monitoring liver function tests is recommended during treatment due to potential hepatotoxicity.
- The choice of antifungal agent will depend upon the clinical status of the patient, the site of infection, and the pharmacokinetics and pharmacodynamics of the agent 3. It's also important to note that some studies have shown that low-dose fluconazole can induce a more rapid clearance of urinary findings than catheter replacement alone 4. However, the most recent and highest quality study should be prioritized when making a definitive recommendation, and in this case, the recommended dose is based on the study by 2.