Prophylaxis of candidiasis in patients with leukemia and bone marrow transplants.
OBJECTIVE
The increased risk for systemic fungal infection and the potential fatal consequences of disseminated candidiasis in bone marrow transplant patients has prompted study of prophylaxis and early treatment of candida colonization and infection.


METHODS
Patients with leukemia who received fluconazole prophylaxis were compared with a concurrent group of patients not given prophylaxis for fungal organisms.


RESULTS
A trend to reduction of oropharyngeal colonization by Candida albicans was seen (p = 0.07) although no significant differences in systemic candidiasis were seen. In patients with documented systemic candidiasis, oral colonization was present and systemic infection was identified after the development of ulcerative oral mucositis.


CONCLUSIONS
Our results support the potential of fluconazole to reduce oropharyngeal colonization by Candida albicans, however, we did not show prophylaxis of oral candidiasis or systemic candidiasis. These findings and reports of fluconazole-resistant candidal species and a rising number of cases of infection as a result of Candida krusei indicate the need for further studies of prophylaxis of candidal infection in patients who are anticipated to develop profound neutropenia.
Epstein
J B
JB
Department of Dentistry, Vancouver Hospital, BC, Canada.
Ransier
A
A
Lunn
R
R
Chin
E
E
Jacobson
J J
JJ
Le
N
N
Reece
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002180:Candidiasis, Oral / Q000517:prevention & control*; D017742:Dental Care for Chronically Ill / Q000379:methods*; D004352:Drug Resistance, Microbial; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D007951:Leukemia, Myeloid / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011292:Premedication; D018709:Statistics, Nonparametric
D000935:Antifungal Agents; D015725:Fluconazole