Peter G. Pappas,1 John H. Rex,2 Jack D. Sobel,3 Scott G. Filler,4 William E. Dismukes,1 Thomas J. Walsh,5 and John E. Edwards4
1Division of Infectious Diseases, University of Alabama at Birmingham, Alabama; 3AstraZeneca Pharmaceuticals, Manchester, Great Britain;
3Wayne State University School of Medicine, Detroit, Michigan; 4Harbor–University of California-Los Angeles Medical Center, Torrance, California;and 5Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland

EXECUTIVE SUMMARY

Candida species are the most common cause of fungal infections. Candida species produce infections that range from non–life-threatening mucocutaneous illnesses
to invasive processes that may involve virtually any organ. Such a broad range of infections requires an equally broad range of diagnostic and therapeutic
strategies. These guidelines summarize current knowledge about treatment of multiple forms of candidiasis for the Infectious Diseases Society of America (IDSA).
Throughout this document, treatment recommendations are rated according to the standard scoring scheme used in other IDSA guidelines to illustrate the strength of the supporting evidence and quality of the underlying data (table 1). This document covers the following 4 major topical areas.

The role of the microbiology laboratory. To a greater extent than for other fungi, treatment of candidiasis can now be guided by in vitro susceptibility testing. However, susceptibility testing of fungi is not considered a routine testing procedure in many laboratories, is not always promptly available, and is not
universally considered as the standard of care. Knowledge of the infecting species, however, is highly predictive of likely susceptibility and can be used as a guide
to therapy. The guidelines review the available infor-mation supporting current testing procedures and interpretive breakpoints and place these data into clinical
context. Susceptibility testing is most helpful in dealing with deep infection due to non–albicans species of Candida.In this setting, especially if the patient has been
treated previously with an azole antifungal agent, the possibility of microbiological resistance must be considered.

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