Fluconazole dose recommendation in urinary tract infection

OBJECTIVE: To identify the most appropriate dose of fluconazole for the treatment of symptomatic fungal urinary tract infection (UTI). DATA SOURCES: Primary literature identified through MEDLINE (1990-June 2000). Key search terms included fluconazole and urinary tract infection. DATA SYNTHESIS: Fluconazole is approved for the treatment of candidal UTIs, but dosage recommendations are not consistent. An evaluation of clinical studies of fluconazole for the treatment of candidal UTI was performed. CONCLUSIONS: Questions remain about the optimal dosing of fluconazole, including the most appropriate dose in non-albicans species of candida as well as the optimal duration of therapy. Until further studies are performed, a fluconazole 200-mg loading dose followed by 100 mg/d for at least four days appears to be the most appropriate dose for the treatment of symptomatic candidal UTI in patients without systemic fungal infection or severe renal failure.