title: Micafungin treatment and eradication of candiduria among hospitalized patients.
abstract: OBJECTIVE
  In high-risk patients, candiduria may be associated with the development of urinary tract infections (UTI) and invasive candidiasis. The triazole antifungals achieve good urine concentrations, but their use is limited by the emergence of non-albicans Candida spp. with low-triazole susceptibility. The echinocandins remain fungicidal against many azole-resistant Candida spp., but low urine concentrations limit their use. We examined the rates of candiduria elimination in micafungin-treated patients.
  
  
  METHODS
  This retrospective analysis evaluated consecutive patients with candiduria (1/2008-4/2011) who were treated with micafungin (100 mg/day) and had post-micafungin urine cultures. Patients were deemed to have either candiduria or UTI and were assessed for short-term (within 2 weeks post-micafungin) and long-term (>1 month post-micafungin) urine sterilization.
  
  
  RESULTS
  Thirty-three patients meeting our inclusion criteria were identified. Of these, 16 (48 %) were diagnosed with a Candida UTI. A total of 25 patients (76 %) had Foley catheters, which were replaced in 11 (44 %) cases. The majority of patients had Candida albicans (39 %), but Candida krusei and Candida glabrata (33 %) were also isolated. Eight patients (24 %) were immunocompromised, and 29 (88 %) received broad-spectrum antibiotics. Rates of urine sterilization during micafungin treatment, 2 weeks after micafungin, and >1 month after micafungin were 81, 78, and 75 %, respectively.
  
  
  CONCLUSIONS
  Among hospitalized patients with candiduria, micafungin administration was frequently associated with both short- and long-term urine sterilization. This was observed among patients with or without Foley removal and among those with Candida albicans, as well as non-albicans Candida spp.
authors: Departments of Transplant Surgery and Pharmacy Services, and the Renal Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. sgabardi@partners.org.|Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. sgabardi@partners.org.|Department of Pharmacy Service, Brigham and Women's Hospital, Boston, MA, 02115, USA. sgabardi@partners.org.
authors: Steven
authors: S
authors: Gabardi
authors: Department of Pharmacy Service, Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors: Spencer
authors: S
authors: Martin
authors: Division of Infectious Diseases, Tufts Medical Center, Boston, MA, USA.
authors: Mihir
authors: M
authors: Sura
authors: Department of Pharmacy Service, Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors: Anisa
authors: A
authors: Mohammed
authors: Division of Infectious Diseases, Tufts Medical Center, Boston, MA, USA.
authors: Yoav
authors: Y
authors: Golan
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy*; D054714:Echinocandins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D055666:Lipopeptides / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D014556:Urine / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin
keywords: Candiduria; Echinocandin; Micafungin; Urinary tract infections