Asymptomatic candiduria (AC): A randomized double blind study of treatment with fluconazole (F) and placebo

J. D. Sobel, D. Mckinsey, C. Kauffman, M. Zervos, Jose Antonio Vazquez, J. Lee

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

AC is extremely common and considerable controversy exists as to indications and best method of treatment 316 hospitalized patients with asymptomatic candiduria (2 positive urine cultures) were randomized to receive fluconazole 200 mg/d or placebo for 14 days. Patients were elderly (mean age 72y) predominantly female, 56% catheterized and with numerous comorbid conditions (diabetes 45%), and groups were well matched demographically including Candida spp, C. albicans 50% (F) and 49% (P). After completion of therapy (day 14), F eradicated candiduria in 50% (79/159) versus 46/157 (29%) of patients receiving P (p<.001). Eradication was significantly increased after catheter removal (78%) versus persistently catheterized (48%) and was reduced in the presence of renal failure and Candida trapicalis infection, but not diabetes. Further follow-up at 2 weeks after therapy, urine infection rates were identical primarily in catheterized subjects. No major adverse events were associated with F use. Symptomatic fungal UTI did not occur in a single patient but mortality due to non-fungal causes in this debilitated population was high (20%). In conclusion, although F is safe and highly effective in achieving Candida negative urine cultures in this population, clinical benefit is not apparent and mycologie relapse is common in catheterized patients.

Original languageEnglish (US)
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - Dec 1 1997
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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