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this review, we have analyzed the available literature pertaining to
the total duration of intravenous (IV) therapy and the appropriate
timing of step down to oral therapy in the management of candidemia.
Overview of the guidelines and literature seem to indicate that a
minimum of 14 days of antifungal therapy is required in the treatment
of candidemia without deeply seated infection. However, this was never
based on evidence. Furthermore, step down to oral therapy seems to be
dependent on the clinical stability criteria of the patient with
candidemia after 4 to 7 days of IV therapy. Further studies are
required to evaluate the appropriate total duration of IV therapy,
appropriate timing of step down to oral therapy and to validate the
clinical criteria that would allow the switch to happen.
Duration of Therapy
Step Down to Oral Therapy
|Figure 1. Proposed timing of step down to oral therapy in the medical literature|
|Table 1. Proposed clinical criteria to determine the eligibility to step down to oral antifungal therapy.|