From the Guidelines
Chronic yeast and bladder infections in male patients require prompt medical evaluation and targeted treatment, with a focus on addressing underlying causes and preventing further complications. For recurrent yeast infections (candidiasis), the most recent and highest quality study 1 recommends a thorough medical history and physical examination, as well as antimicrobial stewardship to combat the rising threat of antimicrobial resistance.
Causes of Recurrent Candidiasis and UTIs
The causes of recurrent candidiasis and UTIs in male patients can be complex and multifaceted, including:
- Underlying medical conditions such as diabetes, immunosuppression, or uncontrolled diabetes
- Anatomical abnormalities or prostate issues
- Poor hygiene practices, such as not cleaning with mild soap, not drying thoroughly, or not wearing breathable cotton underwear
- Exposure to certain medications or substances that can disrupt the balance of the urinary tract
Treatment of Recurrent Candidiasis
For recurrent yeast infections (candidiasis), oral fluconazole 200mg daily for 2 weeks is recommended for cystitis due to fluconazole-susceptible Candida species 1. Topical antifungals like clotrimazole cream applied twice daily for 7-14 days can address acute episodes.
Treatment of UTIs
For chronic bladder infections, a 7-14 day course of antibiotics such as trimethoprim-sulfamethoxazole (Bactrim) 160/800mg twice daily or ciprofloxacin 500mg twice daily is typically prescribed 1. Potential long-term prophylaxis using trimethoprim-sulfamethoxazole 40/200mg daily for 6 months in severe cases may be necessary. Increased fluid intake of 2-3 liters daily helps flush bacteria from the urinary tract.
Importance of Addressing Underlying Causes
Underlying causes must be addressed, including diabetes management, proper hygiene practices, and evaluation for anatomical abnormalities or prostate issues. Patients should complete the full course of prescribed medications even if symptoms improve and follow up with their healthcare provider if symptoms persist. These infections are less common in males than females due to anatomical differences, so persistent infections warrant thorough investigation for underlying conditions such as immunosuppression, uncontrolled diabetes, or structural abnormalities of the urinary tract.
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 causes of recurrent candidiasis (yeast infections) and urinary tract infections (UTIs) in male patients are not directly addressed in the provided drug labels.
- The treatment for Candida urinary tract infections is fluconazole, with daily doses of 50 to 200 mg used in open, noncomparative studies of small numbers of patients 2.
- There is no information provided on the treatment of UTIs caused by bacteria or other pathogens.
- The treatment of recurrent candidiasis is not explicitly stated in the provided drug labels, but fluconazole is used to treat various fungal infections, including oropharyngeal and esophageal candidiasis 2.
- Voriconazole is used to treat candidemia and other deep tissue Candida infections, including infections of the kidney and bladder wall 3.