To : Diane Re : Diflucan and yeast The dose of Diflucan I routinely suggest to physicians and patients is still 200 mg STAT followed by 100 mg daily for mucocutaneous candidiasis. I know others use twice this dose (certain Canadian experts), but studies in the USA seem to suggest that Candida albicans is still pretty sensitive to fluconazole and this dose is still recommended by the infectious disease experts and the package insert. As for duration, that depends on the site of infection. The package insert information is published in my book. For what we are calling 'ductal candidiasis' 2-3 weeks is generally considered requisite. As for this patient, we know that several very resistant Candia species are beginning to arise. This mom may need a vaginal culture to see which strain of candida she really has. Some of them are difficult to eradicate...and the strain is very important in understanding this. Nystatin cream is virtually worthless anymore, and most of my pediatric faculty and residents now use the other azole antifungal creams(miconazole, clotrimazole) instead. As for the statment that "Tom Hale recommends up to 12 weeks on 200 mg/day if yeast recurs after initial 400 mg loading dose and 28 days of 200 mg/day." Twelve weeks of therapy is the dose recommended for cryptococcal meningitis acute" from the manufacturers package insert. This is not the dose for mucocutaneous, or vaginal, or ductal candidiasis. Lets be clear on this. I think the best thing for this mom is to see if she can get a really good culture of this yeast, and identify the strain. Should it be candida albicans, then perhaps she could use the one dose per week method used in immunocompromized individuals. Regards Tom Hale, PH.D. *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html