Pediatric Candidiasis Treatment & Management

  • Author: Sabah Kalyoussef, DO; Chief Editor: Russell W Steele, MD  more...
Updated: Feb 07, 2016

Medical Care

Treatment of candidal infections is primarily accomplished with appropriate antifungal drugs. Mild to moderate infection is initially empirically treated with fluconazole while severe infection is treated with a combination of fluconazole plus liposomal amphotericin B.[5]

Today, neonatal intensive care units (NICUs) in most centers are routinely starting fluconazole prophylaxis in very low birth weight neonates and those with other risk factors to prevent invasive candidiasis.[6, 7, 8, 9]

A study compared the safety and efficacy outcomes of micafungin between prematurely and non-prematurely born infants <2 years of age. The study concluded that micafungin has a safe profile in premature and non-premature infants with substantial efficacy.[10]

The Infectious Diseases Society of America (IDSA) updated their guidelines for managing Candida infections by recommending first-line treatment for candidemia with an echinocandin ( such as caspofungin, micafungin, or anidulafungin), rather than fluconazole, as echinocandins kill, rather than inhibit, these pathogens.[11, 12]


Surgical Care

Remove the offending catheter in central venous catheter infection because attempts to treat the infection without its removal are largely unsuccessful and are accompanied by high morbidity and mortality.



Consult an infectious disease specialist for patients suspected of having systemic candidal infections, especially in the host who is immunocompromised, and consult an ophthalmologist for suspected endophthalmitis in neonates.



No specific diet is required.



No restrictions are required.

Contributor Information and Disclosures

Sabah Kalyoussef, DO Attending Physician, Pediatric Infectious Diseases and Hospital Medicine, The Children's Hospital at St Peter's University Hospital

Sabah Kalyoussef, DO is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, Society for Ear, Nose and Throat Advances in Children, American Federation for Clinical Research, Surgical Infection Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.


Michael E Greenberg, MD, MPH Clinical Instructor, Department of Pediatrics, University of California at San Francisco

Michael E Greenberg, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, and American Public Health Association

Disclosure: Nothing to disclose.

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Typical appearance of thrush. Note multiple white plaques on lips, gingivae, tongue, and palate.
Candidal diaper dermatitis. Note satellite papules and involvement of intertriginous folds.
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