Fungal prophylaxis by reduction of fungal colonization by oral administration of bovine anti-Candida antibodies in bone marrow transplant recipients

Candida overgrowth and invasion constitute a serious threat with a high mor tality in BMT recipients. Currently available topical antifungal prophylaxi s is largely ineffective, and as resistance to existing, absorbable drugs f or systemic use is rapidly developing, new forms of therapy are needed. We investigated the effect of oral treatment of BMT recipients with a bovine i mmunoglobulin product derived from animals immunized against several Candid a species, The natural Candida colonization was first followed in 19 patien ts to establish the colonization pattern. Half of the patients were found t o be colonized prior to transplantation and altogether 72% were colonized a t some point during follow-up, Those with a high pre-transplant concentrati on of Candida in saliva (>100 CFU/ml) remained colonized throughout the BMT treatment period. The therapeutic effect was monitored in two other patien t groups, The first group consisted of nine patients, where, due to a low n umber of primary colonized patients, response in colonized patients was sug gestive of a therapeutic effect. In the second group, 10 patients with a hi gh level of colonization (>100 CFU/ml) were given 10 g daily of the product in three divided doses. The results suggest a treatment-related reduction in Candida colonization in a majority (7/10) of patients and one patient be came completely negative, As no adverse effects were noted, our findings en courage additional studies in immunocompromised, transplant patients.