Fluconazole in the management of fungal urinary tract infections

The presence of Candida in the urine is not considered normal but does not necessarily indicate urinary tract infection. On the other hand, yeasts in urine cultures might be the first symptom of systemic fungal infections. Despite the difficulties that exist, establishment of an accurate diagnosis is important especially in high risk patients because ascending infections may lead to disseminated disease. Amphotericin B bladder irrigation is a common mode of therapy for fungal urinary tract infection, although no specific guidelines exist as to the use of the procedure. The pharmacokinetic parameters possessed by the triazole antifungal agent fluconazole make it a candidate for treating fungal urinary tract infections. Five case reports and 99 patients reported in several small studies were reviewed. As evident from these reports, fluconazole appears to be of value in the treatment of both uncomplicated and complicated fungal urinary tract infections.