EFFECT OF THE CURRENT ANTIMICROBIAL THERAPEUTIC STRATEGY ON FUNGAL COLONIZATION IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES

A ''quasi-experimental'' trial was carried out to investigate the effe ct of three antimicrobial regimens on oral and fecal yeast colonizatio n in patients with hematologic malignancies. Fifty-four patients recei ved ciprofloxacin and oral amphotericin B (group 1); 45 received cefta zidime, amikacin, vancomycin, and oral amphotericin B (group 2); and 3 0 received ceftazidime, amikacin, vancomycin, and intravenous amphoter icin B (group 3). The oral yeast isolation rate showed a decrease in g roup 1 (from 59.3% to 40.7%) and group 3 (from 56.7% to 46.7%), and a marked increase in group 2 (from 51.1% to 84.4%). All the groups showe d a reduction in their fecal yeast isolation rate. An overgrowth of Ca ndida parapsilosis, C. krusei, and C. tropicalis was observed in all t he groups, but it was much higher in group 2. Our findings provide evi dence that ceftazidime, amikacin, and vancomycin, given with oral amph otericin B, induce an overgrowth/persistence of Candida species in the mouth and gut, which might be attributable to inclusion of vancomycin . Treatment with intravenous amphotericin B has at least the capacity of counterbalancing yeast proliferation induced by that antibacterial regimen.