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Cited by 113Antifungal resistance and susceptibilityUrinary Tract Infections ManagementOcular Infections and Treatments

Oral Fluconazole Compared with Bladder Irrigation with Amphotericin B for Treatment of Fungal Urinary Tract Infections in Elderly Patients

Jacobs, L. G., Skidmore, E. A., Freeman, K., Lipschultz, D., Fox, N.·1996·Clinical Infectious Diseases
DOI 10.1093/clinids/22.1.30
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Abstract

Fungal urinary tract infections are increasingly prevalent in the elderly in acute and chronic care settings. This randomized trial compares the efficacy and safety of oral fluconazole with the efficacy and safety of bladder irrigation with amphotericin B for treatment of funguria (> or = 10,000 cfu/mL of urine) in 109 hospitalized elderly patients. A second treatment course was given for persistent funguria. Indwelling bladder catheters were present in 69% of the patients. While Candida albicans was the predominant isolate from catheterized patients, C. albicans, Candida tropicalis, and Torulopsis glabrata were recovered from noncatheterized patients. Two days after completion of treatment, funguria was eradicated in 96% of the patients treated with amphotericin B and 73% of those treated with fluconazole (P < .05). At 1 month after study enrollment, the mortality rate associated with all causes was greater among patients who were treated with amphotericin B bladder irrigation than among those who received oral fluconazole therapy (41% vs. 22%, respectively; P < .05); this finding suggests that local therapy may be associated with poorer survival. The proportion of patients without funguria at 1 month after study enrollment was similar in the two treatment groups (84%, amphotericin B group; 80%, fluconazole group). A few minor and mild adverse events occurred.

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  • Treatment with fluconazole (200 mg/day for 7-14 days) and with amphotericin B deoxycholate at widely ranging doses (0.3-1.0 mg/kg per day for 1-7 days) has been successful for candiduria.

    “Treatment with fluconazole (200 mg/ day for 7-14 days) and with amphotericin B deoxycholate at widely ranging doses (0.3-1.0 mg/kg per day for 1-7 days) has been successful [172] (B-II).”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [172]

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Research works printed but not linked: 2

  1. Joseph CL, Strausbaugh LJ. Funguria in the nursing home. Nursing Home Medicine 1994;2:161-6.
  2. Castiglia M, Fisher M. Use of fluconazole in the treatment of candiduria: a retrospective view [abstract F-49]. In: Proceedings of the 93rd General Meeting of the American Society for Microbiology (Atlanta). Washing- ton, DC: American Society for Microbiology, 1993:535.

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Authors
Jacobs, L. G., Skidmore, E. A., Freeman, K., Lipschultz, D., & Fox, N.
Affiliations
  • Montefiore Medical Center (US)
  • Albert Einstein College of Medicine (US)
Corresponding author
Jacobs, L. G.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1996-01-01
Volume
22
Issue
1
Pages
30-35
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/clinids/22.1.30
OpenAlex
W2117917197
Cited by
113
References
27
Citations by year
2026: 4 · 2025: 2 · 2024: 1 · 2022: 1 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 2 · 2013: 2
FWCI
5.54
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
Pfizer
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
fungal urinary tract infection, funguria, fluconazole, amphotericin B, bladder irrigation, elderly patients, indwelling urinary catheter, Candida albicans, Candida tropicalis, Candida glabrata, mortality, treatment efficacy and safety
MeSH terms
Administration, Oral, Aged, Aged, 80 and over, Amphotericin B, Urinary Bladder, Candidiasis, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Therapeutic Irrigation, Male, Urinary Tract Infections, Fluconazole, Treatment Outcome

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