All of the following are effective in the treatment of Candida albicans fungemia except:
Correct Answer: Terbinafine
Description: All patients with Candida fungemia should be treated with systemic antifungals. Terbinafine (non-competitive inhibitor of squalene epoxide) is an agent used for dermatophyte infection. Fluconazole has been shown to be an effective agent for candidemia. Voriconazole is also active against Candida albicans but has many drug interactions. Caspofungin and other Echinocandins are gaining popularity due to their broad efficacy against most yeast isolates and better side-effect profile. Amphotericin B is effective in fungemia. S/E: rigors, electrolyte wasting, and renal insufficiency. Newer lipid formulations mitigate these effects to varying extents.
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