ORAL FLUCONAZOLE FOR CANDIDA URINARY-TRACT INFECTION

Fungal urinary tract infections are increasingly prevalent in hospital ized patients. This trial compares the efficacy of oral fluconazole al ong with catheter replacement to that of catheter replacement alone fo r treatment of funguria. The study group patients (n = 30) were given 100 mg of fluconazole followed by 50 mg/day for 14 days and had their catheters replaced on day one. The control group, randomized on a 1:1 basis (n = 30) had only a catheter replacement. Seventeen and 21 patie nts in the study and control groups, respectively, had Candida albican s, 8 and 5 had Candida tropicalis, and 5 and 4 had Candida glabrata. T he MICs of the organisms were determined by the E test. The MIC90 of t he C. albicans, C. tropicalis, and C. glabrata were 12, 16, and 64 mu g/ml, respectively. Funguria disappeared in all study group patients w ithin a week but recurred in only 1 patient 8 weeks after enrollment i n the study. Although fluconazole caused a more rapid and an almost co mplete eradication of funguria and urinary WBCs, catheter replacement alone was followed by an 87-93 % clearance of urinary findings at 8 we eks of follow-up. These results suggest that in patients with funguria low-dose fluconazole induces a more rapid clearance of urinary findin gs than does catheter replacement alone.