Candida urinary tract infections - Treatment

John Fremont Fisher, Jack D. Sobel, Carol A. Kauffman, Cheryl L Newman

Research output: Contribution to journalArticle

Abstract

In many instances a report from the clinical laboratory indicating candiduria represents colonization or procurement contamination of the specimen and not invasive candidiasis. Even if infection of the urinary tract by Candida species can be confirmed, antifungal therapy is not always warranted. Further investigation may reveal predisposing factors, which if corrected or treated, result in the resolution of the infection. For those with symptomatic urinary tract infections (UTIs), the choice of antifungal agent will depend upon the clinical status of the patient, the site of infection, and the pharmacokinetics and pharmacodynamics of the agent. Because of its safety, achievement of high concentrations in the urine, and availability in both an oral and intravenous formulation, fluconazole is preferred for the treatment of Candida UTIs. Flucytosine is concentrated in urine and has broad activity against Candida spp, but its use requires caution because of toxicity. Low-dose amphotericin B may be useful for Candida UTIs in selected patients. The role of echinocandins and azoles that do not achieve measurable concentrations in the urine is not clear. Small case series note some success, but failures have also occurred. Irrigation of the bladder with antifungal agents has limited utility. However, with fungus balls, irrigation of the renal pelvis through a nephrostomy tube can be useful in combination with systemic antifungal agents.

Original languageEnglish (US)
JournalClinical Infectious Diseases
Volume52
Issue numberSUPPL. 6
DOIs
StatePublished - May 15 2011

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Candida
Urinary Tract Infections
Antifungal Agents
Urine
Invasive Candidiasis
Echinocandins
Flucytosine
Azoles
Kidney Pelvis
Fluconazole
Amphotericin B
Therapeutics
Infection
Causality
Urinary Bladder
Fungi
Pharmacokinetics
Safety

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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Candida urinary tract infections - Treatment. / Fisher, John Fremont; Sobel, Jack D.; Kauffman, Carol A.; Newman, Cheryl L.

In: Clinical Infectious Diseases, Vol. 52, No. SUPPL. 6, 15.05.2011.

Research output: Contribution to journalArticle

Fisher, John Fremont ; Sobel, Jack D. ; Kauffman, Carol A. ; Newman, Cheryl L. / Candida urinary tract infections - Treatment. In: Clinical Infectious Diseases. 2011 ; Vol. 52, No. SUPPL. 6.
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