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Clearance of funguria with short-course antifungal regimens: a prospective, randomized, controlled study
1Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
Abstract:
The effects of short-course antifungal regimens on funguria were studied in 180 hospitalized adults who did not have ascending urinary or deep fungal infections but did have > 1,000 cfu of yeast/mL in two consecutive urine cultures. Before treatment, efforts were made to eliminate factors conducive to funguria. No additional interventions were implemented in the management of the control group (group A), whereas five experimental groups received short-course therapy as follows: oral administration of fluconazole (group B); single-dose intravenous administration of amphotericin B (group C); and intermittent bladder irrigation with amphotericin B at low, medium, and high concentrations (groups D, E, and F, respectively). Urine was cultured on days 1 and 7 after antifungal treatment. The rate of spontaneous clearance of funguria in the control group was 40.0%. Rates of clearance in experimental groups B through F were 58.6%, 55.2%, 82.1% (P < .01), 86.7% (P < .001), and 83.3% (P < .001), respectively, on day 1 and 77.3% (P < .01), 72.0% (P < .05), 42.9%, 68.4%, and 68.2% (P < .05), respectively, on day 7. The decrement in yeast count was 60.8% for the control group. Decrements for experimental groups B through F were 80.5%, 74.2%, 94.2% (P < .01), 86.7% (P < .05), and 95.3% (P < .001), respectively, on day 1 and 85.5% (P < .05), 80.7%, 75.7%, 87.9% (P < .05), and 76.4%, respectively, on day 7.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Short-course antifungal treatments effectively cleared funguria in hospitalized adults. Amphotericin B bladder irrigation and oral fluconazole showed significant clearance rates compared to no treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Funguria, yeast in urine, affects hospitalized patients.
- Risk factors for funguria include indwelling catheters and antibiotic use.
- Short-course antifungal therapy is being investigated for efficacy.
Purpose of the Study:
- To evaluate the effectiveness of short-course antifungal regimens in treating funguria.
- To compare different antifungal treatments including oral fluconazole and amphotericin B bladder irrigation.
Main Methods:
- 180 hospitalized adults with funguria were divided into a control group and five experimental groups.
- Experimental groups received oral fluconazole, intravenous amphotericin B, or amphotericin B bladder irrigation.
- Urine cultures were performed on days 1 and 7 post-treatment to assess yeast clearance.
Main Results:
- Amphotericin B bladder irrigation (low, medium, high concentrations) showed high clearance rates (82.1%-86.7% on day 1, 42.9%-68.4% on day 7).
- Oral fluconazole achieved 58.6% clearance on day 1 and 77.3% on day 7.
- All experimental groups demonstrated higher clearance rates than the control group (40.0% spontaneous clearance).
Conclusions:
- Short-course antifungal therapies, particularly amphotericin B bladder irrigation, are effective in treating funguria.
- These regimens offer a viable alternative to prolonged treatments for uncomplicated funguria.