Prevention and therapy of fungal infection in severe acute pancreatitis: A prospective clinical study.
OBJECTIVE
To investigate the prevention and therapy of fungal infection in patients with severe acute pancreatitis (SAP).


METHODS
Seventy patients with SAP admitted from Jan. 1998 to Dec. 2002 were randomly divided into garlicin prevention group, fluconazole (low dosage) prevention group and control group. The incidence of fungal infection, the fungal clearance and mortality after treatment were compared.


RESULTS
The incidence of fungal infection in garlicin group and fluconazole group was lower than that in control group (16% vs 30%, P<0.05 and 9% vs 30%, P<0.01, respectively). Amphotericin B or therapy-dose fluconazole had effects on patients with fungal infection in garlicin group and control group, but had no effects on patients with fungal infection in fluconzole group.


CONCLUSIONS
Prophylactic dosage of antifungal agents (garlicin or low dosage fluconazole) can reduce the incidence of fungal infection in patients with SAP. But once fungal infection occurs, amphotericin B should be used as early as possible if fluconazole is not effective.
He
Yue-Ming
YM
Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China. heym@medmail.com.cn
Lv
Xin-Sheng
XS
Ai
Zhong-Li
ZL
Liu
Zhi-Su
ZS
Qian
Qun
Q
Sun
Quan
Q
Chen
Ji-Wei
JW
Lei
Dao-Xiong
DX
Jiang
Cong-Qing
CQ
Yuan
Yu-Fong
YF
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000498:Allyl Compounds / Q000008:administration & dosage; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage*; D004220:Disulfides / Q000008:administration & dosage; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D010195:Pancreatitis / Q000382:microbiology* / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome
D000498:Allyl Compounds; D000935:Antifungal Agents; D004220:Disulfides; C028009:diallyl disulfide; D000666:Amphotericin B; D015725:Fluconazole