Fluconazole failure in two cases of disseminated candidosis

Amphotericin B has been the standard treatment of disseminated candidosis although the less toxic fluconazole tends to be used more frequently. In a recent report, no significant difference in the efficacy of candidaemia treatment was observed between fluconazole and amphotericin B. However, we report on 2 cases of invasive candidosis where fluconazole failed to eradicate Candida albicans although the isolates were susceptible to fluconazole in vitro. Pulsed-field gel electrophoresis was used to confirm the persistence of the same C. albicans strain after therapy failure in both patients.