TREATMENT OF CANDIDEMIA IN CRITICALLY ILL SURGICAL PATIENTS WITH INTRAVENOUS FLUCONAZOLE

Six nonneutropenic, critically ill patients with candidemia who underw ent surgery were treated with intravenous fluconazole, a new, nontoxic triazole derivative. The portal of entry for Candida species could be demonstrated for four patients (the peritoneal cavity in two and a ce ntral venous catheter in two). There were three cases of fungemia due to Candida albicans; two cases were due to Candida tropicalis, and one case was due to Candida parapsilosis. Fluconazole was administered to these patients for a mean of 20 days at doses ranging from 100 to 200 mg/d. All patients survived and Candida species were eradicated from all sites. The decision to treat patients with proven or suspected sys temic candidiasis has been made easier by the development of new, nont oxic antifungal agents.