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Prophylaxis of candidiasis in patients with leukemia and bone marrow transplants.

Abstract

OBJECTIVES

The increased risk for systemic fungal infection and the potential fatal consequences of disseminated candidiasis in bone marrow transplant patients has prompted study of prophylaxis and early treatment of candida colonization and infection.

STUDY DESIGN

Patients with leukemia who received fluconazole prophylaxis were compared with a concurrent group of patients not given prophylaxis for fungal organisms.

RESULTS

A trend to reduction of oropharyngeal colonization by Candida albicans was seen (p = 0.07) although no significant differences in systemic candidiasis were seen. In patients with documented systemic candidiasis, oral colonization was present and systemic infection was identified after the development of ulcerative oral mucositis.

CONCLUSIONS

Our results support the potential of fluconazole to reduce oropharyngeal colonization by Candida albicans, however, we did not show prophylaxis of oral candidiasis or systemic candidiasis. These findings and reports of fluconazole-resistant candidal species and a rising number of cases of infection as a result of Candida krusei indicate the need for further studies of prophylaxis of candidal infection in patients who are anticipated to develop profound neutropenia.

Authors+Show Affiliations

Department of Dentistry, Vancouver Hospital, BC, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8653462

Citation

Epstein, J B., et al. "Prophylaxis of Candidiasis in Patients With Leukemia and Bone Marrow Transplants." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 81, no. 3, 1996, pp. 291-6.
Epstein JB, Ransier A, Lunn R, et al. Prophylaxis of candidiasis in patients with leukemia and bone marrow transplants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(3):291-6.
Epstein, J. B., Ransier, A., Lunn, R., Chin, E., Jacobson, J. J., Le, N., & Reece, D. (1996). Prophylaxis of candidiasis in patients with leukemia and bone marrow transplants. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 81(3), 291-6.
Epstein JB, et al. Prophylaxis of Candidiasis in Patients With Leukemia and Bone Marrow Transplants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(3):291-6. PubMed PMID: 8653462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylaxis of candidiasis in patients with leukemia and bone marrow transplants. AU - Epstein,J B, AU - Ransier,A, AU - Lunn,R, AU - Chin,E, AU - Jacobson,J J, AU - Le,N, AU - Reece,D, PY - 1996/3/1/pubmed PY - 1996/3/1/medline PY - 1996/3/1/entrez SP - 291 EP - 6 JF - Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics JO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod VL - 81 IS - 3 N2 - OBJECTIVES: The increased risk for systemic fungal infection and the potential fatal consequences of disseminated candidiasis in bone marrow transplant patients has prompted study of prophylaxis and early treatment of candida colonization and infection. STUDY DESIGN: Patients with leukemia who received fluconazole prophylaxis were compared with a concurrent group of patients not given prophylaxis for fungal organisms. RESULTS: A trend to reduction of oropharyngeal colonization by Candida albicans was seen (p = 0.07) although no significant differences in systemic candidiasis were seen. In patients with documented systemic candidiasis, oral colonization was present and systemic infection was identified after the development of ulcerative oral mucositis. CONCLUSIONS: Our results support the potential of fluconazole to reduce oropharyngeal colonization by Candida albicans, however, we did not show prophylaxis of oral candidiasis or systemic candidiasis. These findings and reports of fluconazole-resistant candidal species and a rising number of cases of infection as a result of Candida krusei indicate the need for further studies of prophylaxis of candidal infection in patients who are anticipated to develop profound neutropenia. SN - 1079-2104 UR - https://www.unboundmedicine.com/medline/citation/8653462/Prophylaxis_of_candidiasis_in_patients_with_leukemia_and_bone_marrow_transplants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1079-2104(96)80328-3 DB - PRIME DP - Unbound Medicine ER -