Version July 2025
| Condition or treatment group | Therapy | ||
| Primary | Alternative | Comments | |
| Osteomyelitis | Fluconazole 400 mg (6 mg/kg) orally* daily for 6 to 12 months or An echinocandin (1 of the following, for at least 2 weeks):
Followed by fluconazole 400 mg (6 mg/kg) orally daily for 6 to 12 months | Lipid formulation of amphotericin B 3 to 5 mg/kg IV daily (for at least 2 weeks), followed by fluconazole 400 mg (6 mg/kg) orally daily (for 6 to 12 months) | Duration of therapy is prolonged (6 to 12 months). Surgical debridement is frequently necessary. |
| Septic arthritis | Fluconazole 400 mg (6 mg/kg) orally* daily for 6 weeks or An echinocandin (1 of the following, for 2 weeks):
Followed by fluconazole 400 mg (6 mg/kg) orally daily for at least 4 weeks | Lipid formulation of amphotericin B 3 to 5 mg/kg IV daily (for at least 2 weeks), followed by fluconazole 400 mg (6 mg/kg) orally daily (for at least 4 weeks) | Duration of therapy is usually for at least 6 weeks, but few data are available. Surgical drainage is recommended for all cases. For infected prosthetic joints, removal is recommended for most cases. If the prosthetic device cannot be removed, chronic suppression with fluconazole 400 mg (6 mg/kg) orally daily should be given if the isolate is susceptible. |
IV: intravenously.
* Since fluconazole is highly bioavailable, oral therapy is appropriate for most patients. IV therapy with an echinocandin or fluconazole (at the same dose as the oral dose) should be given to patients who are unable to take oral medications, who are not expected to have good gastrointestinal absorption, or who are severely ill. Patients treated initially with IV fluconazole should be transitioned to oral fluconazole when feasible.