Bladder irrigation with amphotericin B for treatment of fungal urinary tract infections

Fungal urinary tract infection has become a frequent clinical entity. Despite limited evaluation of its efficacy, bladder irrigation with amphotericin B has become the usual means of therapy for such infections. The outcome of treatment with amphotericin B bladder irrigation for an average of 5 days for 95 hospitalized patients with funguria (mean age, 75 years) during a 14-month period is presented. All patients who received treatment were identified from pharmacy records; those for whom urine culture results were obtained after treatment were studied. Fever and/or pyuria was identified in the majority of cases. Funguria was eradicated in 80% (confidence interval, 72%-88%). Concomitant diabetes mellitus or the previous use of indwelling bladder catheters did not alter response to treatment. The mortality rate following treatment of funguria was 39%, compared to 30.5% for a similar population during the same period. Amphotericin B bladder irrigation may not prove to be ideal therapy despite the fact that it initially eradicated funguria in the majority of subjects in this study.