Fluconazole treatment of candidal infections caused by non-albicans Candida species

Fluconazole is an effective alternative to amphotericin B for the treatment of serious infections caused by Candida albicans. Through a literature survey of candidal infections caused by non-albicans Candida spp., 43 cases treated with fluconazole were found. The most common causative organisms were Candida parapsilosis (14 patients), Candida glabrata (12 patients), and Candida tropicalis (11 patients). The dose of fluconazole varied from 50 to 400 mg daily. The median duration of treatment was 21 days. Overall efficacy was 77%. The efficacy against the various species was 93% for Candida parapsilosis, 50% for Candida glabrata, and 82% for Candida tropicalis. In conclusion, fluconazole is effective against the most common non-albicans Candida spp., although higher doses may be required for infections caused by Candida glabrata. Infections caused by Candida krusei should not be treated with fluconazole.