[Clinical evaluation of flucytosine in patients with urinary fungal infections].
The clinical effectiveness of flucytosine (5-FC) was evaluated in 52 patients with urinary fungal infections which were diagnosed because of the presence of both funguria (greater than or equal to 10(4) cfu/ml) and pyuria (greater than or equal to 5 WBC/hpf). The patients received oral daily doses of 5-FC ranging 20 to 150 mg/kg, with a mean treatment duration of 11 days. The 57 fungus strains isolated from urine specimens consisted of 51 Candida spp. including 28 Candida albicans, 10 Candida glabrata, 4 Candida tropicalis and 6 Trichosporon beigelii. Forty-seven (92.2%) and 4 (66.7%) of the 51 Candida spp. and 6 T. beigelii strains isolated were eradicated by the treatment, respectively, giving an overall eradication rate of 89.5%. Clinical responses in 32 patients, from whom only fungi were submitted, were excellent in 5, moderate in 22, and poor in 5, thus the overall efficacy rate was 84.4%, based on the criteria of Japanese UTI Committee. Of the 18 strains of Candida spp. tested, 5-FC showed 0.20 micrograms/ml or less of the minimum inhibitory concentrations (MICs) against 16 strains and higher than 100 micrograms/ml against the remaining 2 strains. The MICs of the 5 T. beigelii strains tested were between 3.12 and 6.25 micrograms/ml. As adverse reactions, only 2 patients (3.8%) experienced diarrhea but did not require treatment cessation. These results suggest that flucytosine is an effective drug for urinary fungal infections.
Tokunaga
S
S
Department of Urology, School of Medicine, Kanazawa University.
Ohkawa
M
M
Nakashima
T
T
Yamaguchi
K
K
Nishikawa
T
T
Matsushita
T
T
Mikawa
I
I
Hirano
S
S
Kawaguchi
S
S
Miyagi
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology; D004341:Drug Evaluation; D004352:Drug Resistance, Microbial; D005260:Female; D005437:Flucytosine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D014250:Trichosporon / Q000187:drug effects / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
D005437:Flucytosine