Empiric coverage of Candida spp not recommended unless yeast/Candida on Gram smear/culture AND at least one of below:

  • yeast seen intracellularly or presence of pseudohyphae
  • patient on immunosuppressive therapy
  • multiple previous antibiotics
  • upper GI tract perforation
  • postoperative intra-abdominal infection
  • recurrent intra-abdominal infection.

Add fluconazole if C. albicans, or an echinocandin (caspofungin or micafungin) if nonalbicans Candida spp.