A RANDOMIZED STUDY COMPARING FLUCONAZOLE WITH AMPHOTERICIN B 5-FLUCYTOSINE FOR THE TREATMENT OF SYSTEMIC CANDIDA INFECTIONS IN INTENSIVE-CARE PATIENTS/

In this prospective, randomized study fluconazole and amphotericin B/5 -flucytosine were compared in the treatment of systemic candidiasis. S eventy-two non-neutropenic intensive care patients with systemic Candi da infections were enrolled, Thirty-six patients were randomly assigne d to receive fluconazole (400 mg on the first day then 200 mg) and 36 were randomized to amphotericin B/5-flucytosine (1.0-1.5 mg/kg body we ight every other day and 3x2.5 g flucytosine/day) for 14 days followin g the diagnosis, There was no statistically significant difference in clinical outcome in regard to the treatment of pneumonia and sepsis: 1 8/28 of the patients were treated successfully with fluconazole and 17 /27 with amphotericin B/5-flucytosine. For the treatment of peritoniti s, however, amphotericin B/5-flucytosine was more effective than fluco nazole (55 % vs, 25 %), Furthermore, amphotericin B/5-flucytosine was found to be superior to fluconazole with regard to pathogen eradicatio n (86% vs, 50%), Fluconazole was associated with less toxicity than am photericin B/5-flucytosine.