PROPHYLAXIS OF CANDIDIASIS IN PATIENTS WITH LEUKEMIA AND BONE-MARROW TRANSPLANTS

Objectives. The increased risk for systemic fungal infection and the p otential fatal consequences of disseminated candidiasis in bone marrow transplant patients has prompted study of prophylaxis and early treat ment of candida colonization and infection. Study design. Patients wit h leukemia who received fluconazole prophylaxis were compared with a c oncurrent group of patients not given prophylaxis for fungal organisms . Results. A trend to reduction of oropharyngeal colonization by Candi da albicans was seen (p = 0.07) although no significant differences in systemic candidiasis were seen. In patients with documented systemic candidiasis, oral colonization was present and systemic infection was identified after the development of ulcerative oral mucositis. Conclus ions. Our results support the potential of fluconazole to reduce oroph aryngeal colonization caused by Candida albicans, however, we did not show prophylaxis of oral candidiasis or systemic candidiasis. These fi ndings and reports of fluconazole-resistant candidal species and a ris ing number of cases of infection as a result of Candida krusei indicat e the need for further studies of prophylaxis of candidal infection in patients who are anticipated to develop profound neutropenia.