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[Treatment of complicated urinary tract infections caused by fungi]
Abstract:
The predisposing factors of funguria and the clinical efficacy of treatment with ketoconazole, a new oral imidazole antifungal drug were studied in 10 patients with complicated urinary tract infection due to fungi. Preceding antibiotic therapy, presence of indwelling catheter and malignant tumor were regarded as the important factors that predisposed to the fungal urinary tract infections. Patients received 200 mg of ketoconazole once a day for 5 to 14 days. Of the 9 patients in whom clinical efficacy of ketoconazole was evaluated, excellent response was obtained in 4 patients, moderate in 2 and poor in 3 patients. Of the 9 strains of fungi isolated before treatment, 6 strains or 67% were eradicated after treatment. Neither subjective nor objective side effects were observed in any of 10 patients receiving ketoconazole, and laboratory tests showed elevated BUN and serum creatinine in 1 patient. From the results obtained in this study, ketoconazole was regarded as useful in the treatment of complicated urinary tract infection due to fungi.
Insights
Ketoconazole shows promise for treating fungal urinary tract infections, with 67% of fungal strains eradicated. This new oral antifungal drug was well-tolerated by patients, indicating its potential utility.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Context:
- Complicated urinary tract infections (UTIs) can be caused by fungi.
- Predisposing factors include prior antibiotic use, indwelling catheters, and malignancy.
- Fungal UTIs pose a significant clinical challenge.
Purpose:
- To investigate predisposing factors for funguria.
- To evaluate the clinical efficacy and safety of ketoconazole for treating fungal UTIs.
Summary:
- Ten patients with complicated fungal UTIs were treated with oral ketoconazole (200 mg daily for 5-14 days).
- Clinical efficacy was observed in 6 out of 9 evaluable patients (4 excellent, 2 moderate, 3 poor responses).
- Fungal eradication was achieved in 67% of pre-treatment isolates, with minimal side effects reported.
Impact:
- Ketoconazole demonstrates potential as a useful therapeutic option for complicated fungal urinary tract infections.
- The study highlights the importance of identifying predisposing factors for timely intervention.
- Further research may establish ketoconazole as a standard treatment for this condition.