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Fluconazole in the management of fungal urinary tract infections

Einsatz von Fluconazol bei durch Hefen verursachten Harnwegsinfektionen

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Summary

The presence ofCandida in the urine is not considered normal but does not necessarily indicate urinary tract infection. On the other hand, yeasts in urine cultures might be the first symptom of systemic fungal infections. Despite the difficulties that exist, establishment of an accurate diagnosis is important especially in high risk patients because ascending infections may lead to disseminated disease. Amphotericin B bladder irrigation is a common mode of therapy for fungal urinary tract infection, although no specific guidelines exist as to the use of the procedure. The pharmacokinetic parameters posessed by the triazole antifungal agent fluconazole make it a candidate for treating fungal urinary tract infections. Five case reports and 99 patients reported in several small studies were reviewed. As evident from these reports, fluconazole appears to be of value in the treatment of both uncomplicated and complicated fungal urinary tract infections.

Zusammenfassung

ObwohlCandida für gewöhnlich nicht im Urin vorkommt, läßt der Nachweis nicht sicher auf eine Harnwegsinfektion schließen. Andererseits kann der Nachweis von Hefen im Urin das erste Symptom einer systemischen Mykose sein. Trotz der bestehenden Probleme ist eine akkurate Diagnose, insbesondere bei Risikopatienten, von besonderer Bedeutung, da aszendierende Infektionen zur systemischen Erkrankung führen können. Amphotericin-B-Blasenspülung ist eine gebräuchliche Therapieform bei durch Pilzen verursachten Harnwegsinfektionen, obwohl keine spezifischen Richtlinien für diese Anwendung bestehen. Fluconazol erscheint aufgrund seiner Pharmakokinetik ideal für den Einsatz bei Harnwegsinfektionen. Die Ergebnisse von 5 Fallberichten und 99 Patienten aus verschiedenen, kleineren Studien, sind in diesem Review zusammengefaßt. Anhand der Ergebnisse dieser Studien erscheint der Einsatz von Fluconazol bei unkomplizierten und kompliziertenCandida-Harnwegsinfektionen gerechtfertigt.

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Authors and Affiliations

  1. Dept. of Medical Microbiology, University Hospital Nijmegen, St. Radboud, P. O. Box 9101, NL-6500, Nijmegen, The Netherlands

    A. Voss M. D., J. F. G. M. Meis M. D., Ph. D. &  J. A. A. Hoogkamp-Korstanje M. D., Ph. D.

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  1. A. Voss M. D.
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  2. J. F. G. M. Meis M. D., Ph. D.
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Voss, A., Meis, J.F.G.M. & Hoogkamp-Korstanje, J.A.A. Fluconazole in the management of fungal urinary tract infections. Infection 22, 247–251 (1994). https://doi.org/10.1007/BF01739908

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