Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo

Jack D. Sobel; C. A. Kauffman; D. McKinsey; M. Zervos; J. A. Vazquez; A. W. Karchmer; J. Lee; C. Thomas; H. Panzer; W. E. Dismukes; John H. Pottage; Gilbert J. Wise; Brian Simmons; Charles Cherubin; Susan Hadley; Douglas A. Holt; Daniel Hirsch; Melanie A. Fisher; Harry Gallis; Phillip Johnson; Brad Doebbeling; James Rahal; Richard Hamill; John Stern; Patricia K. Sharkey; Richard Mangi; Robert Rubin; Alan Sugar; Peter Pappas

doi:10.1086/313580

Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo

Jack D. Sobel, C. A. Kauffman, D. McKinsey, M. Zervos, J. A. Vazquez, A. W. Karchmer, J. Lee, C. Thomas, H. Panzer, W. E. Dismukes, John H. Pottage, Gilbert J. Wise, Brian Simmons, Charles Cherubin, Susan Hadley, Douglas A. Holt, Daniel Hirsch, Melanie A. Fisher, Harry Gallis, Phillip JohnsonBrad Doebbeling, James Rahal, Richard Hamill, John Stern, Patricia K. Sharkey, Richard Mangi, Robert Rubin, Alan Sugar, Peter Pappas

Research output: Contribution to journal › Article › peer-review

274 Scopus citations

Abstract

Management of candiduria is limited by the lack of information about its natural history and lack of data from controlled studies on the efficacy of treating it with antimycotic agents. We compared fungal eradication rates among 316 consecutive candiduric (asymptomatic or minimally symptomatic) hospitalized patients treated with fluconazole (200 mg) or placebo daily for 14 days. In an intent-to-treat analysis, candiduria cleared by day 14 in 79 (50%) of 159 receiving fluconazole and 46 (29%) of 157 receiving placebo (P<.001), with higher eradication rates among patients completing 14 days of therapy (P<.0001), including 33 (52%) of 64 catheterized and 42 (78%) of 54 noncatheterized patients. Pretreatment serum creatinine levels were inversely related to candiduria eradication. Fluconazole initially produced high eradication rates, but cultures at 2 weeks revealed similar candiduria rates among treated and untreated patients. Oral fluconazole was safe and effective for short-term eradication of candiduria, especially following catheter removal. Long-term eradication rates were disappointing and not associated with clinical benefit.

Original language	English (US)
Pages (from-to)	19-24
Number of pages	6
Journal	Clinical Infectious Diseases
Volume	30
Issue number	1
DOIs	https://doi.org/10.1086/313580
State	Published - 2000
Externally published	Yes

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1086/313580

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Sobel, J. D., Kauffman, C. A., McKinsey, D., Zervos, M., Vazquez, J. A., Karchmer, A. W., Lee, J., Thomas, C., Panzer, H., Dismukes, W. E., Pottage, J. H., Wise, G. J., Simmons, B., Cherubin, C., Hadley, S., Holt, D. A., Hirsch, D., Fisher, M. A., Gallis, H., ... Pappas, P. (2000). Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo. Clinical Infectious Diseases, 30(1), 19-24. https://doi.org/10.1086/313580

Sobel, JD, Kauffman, CA, McKinsey, D, Zervos, M, Vazquez, JA, Karchmer, AW, Lee, J, Thomas, C, Panzer, H, Dismukes, WE, Pottage, JH, Wise, GJ, Simmons, B, Cherubin, C, Hadley, S, Holt, DA, Hirsch, D, Fisher, MA, Gallis, H, Johnson, P, Doebbeling, B, Rahal, J, Hamill, R, Stern, J, Sharkey, PK, Mangi, R, Rubin, R, Sugar, A & Pappas, P 2000, 'Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo', Clinical Infectious Diseases, vol. 30, no. 1, pp. 19-24. https://doi.org/10.1086/313580

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title = "Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo",

abstract = "Management of candiduria is limited by the lack of information about its natural history and lack of data from controlled studies on the efficacy of treating it with antimycotic agents. We compared fungal eradication rates among 316 consecutive candiduric (asymptomatic or minimally symptomatic) hospitalized patients treated with fluconazole (200 mg) or placebo daily for 14 days. In an intent-to-treat analysis, candiduria cleared by day 14 in 79 (50%) of 159 receiving fluconazole and 46 (29%) of 157 receiving placebo (P<.001), with higher eradication rates among patients completing 14 days of therapy (P<.0001), including 33 (52%) of 64 catheterized and 42 (78%) of 54 noncatheterized patients. Pretreatment serum creatinine levels were inversely related to candiduria eradication. Fluconazole initially produced high eradication rates, but cultures at 2 weeks revealed similar candiduria rates among treated and untreated patients. Oral fluconazole was safe and effective for short-term eradication of candiduria, especially following catheter removal. Long-term eradication rates were disappointing and not associated with clinical benefit.",

author = "Sobel, {Jack D.} and Kauffman, {C. A.} and D. McKinsey and M. Zervos and Vazquez, {J. A.} and Karchmer, {A. W.} and J. Lee and C. Thomas and H. Panzer and Dismukes, {W. E.} and Pottage, {John H.} and Wise, {Gilbert J.} and Brian Simmons and Charles Cherubin and Susan Hadley and Holt, {Douglas A.} and Daniel Hirsch and Fisher, {Melanie A.} and Harry Gallis and Phillip Johnson and Brad Doebbeling and James Rahal and Richard Hamill and John Stern and Sharkey, {Patricia K.} and Richard Mangi and Robert Rubin and Alan Sugar and Peter Pappas",

note = "Funding Information: Received 16 November 1998; revised 6 April 1999; electronicallypublished 6 January 2000. Financial support: Pfizer Pharmaceutical, Inc. and National Institutes of Health (contract no. NO1-A1-15082). a A list of participating investigators appears at the end of the text. Reprints or correspondence: Dr. Jack D. Sobel, Harper Professional Building, Ste. 2140, 4160 John R Street, Detroit, MI 48201 (jsobel@intmed .wayne.edu).",

year = "2000",

doi = "10.1086/313580",

language = "English (US)",

volume = "30",

pages = "19--24",

journal = "Clinical Infectious Diseases",

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T1 - Candiduria

T2 - A randomized, double-blind study of treatment with fluconazole and placebo

AU - Sobel, Jack D.

AU - Kauffman, C. A.

AU - McKinsey, D.

AU - Zervos, M.

AU - Vazquez, J. A.

AU - Karchmer, A. W.

AU - Lee, J.

AU - Thomas, C.

AU - Panzer, H.

AU - Dismukes, W. E.

AU - Pottage, John H.

AU - Wise, Gilbert J.

AU - Simmons, Brian

AU - Cherubin, Charles

AU - Hadley, Susan

AU - Holt, Douglas A.

AU - Hirsch, Daniel

AU - Fisher, Melanie A.

AU - Gallis, Harry

AU - Johnson, Phillip

AU - Doebbeling, Brad

AU - Rahal, James

AU - Hamill, Richard

AU - Stern, John

AU - Sharkey, Patricia K.

AU - Mangi, Richard

AU - Rubin, Robert

AU - Sugar, Alan

AU - Pappas, Peter

N1 - Funding Information: Received 16 November 1998; revised 6 April 1999; electronicallypublished 6 January 2000. Financial support: Pfizer Pharmaceutical, Inc. and National Institutes of Health (contract no. NO1-A1-15082). a A list of participating investigators appears at the end of the text. Reprints or correspondence: Dr. Jack D. Sobel, Harper Professional Building, Ste. 2140, 4160 John R Street, Detroit, MI 48201 (jsobel@intmed .wayne.edu).

PY - 2000

Y1 - 2000

N2 - Management of candiduria is limited by the lack of information about its natural history and lack of data from controlled studies on the efficacy of treating it with antimycotic agents. We compared fungal eradication rates among 316 consecutive candiduric (asymptomatic or minimally symptomatic) hospitalized patients treated with fluconazole (200 mg) or placebo daily for 14 days. In an intent-to-treat analysis, candiduria cleared by day 14 in 79 (50%) of 159 receiving fluconazole and 46 (29%) of 157 receiving placebo (P<.001), with higher eradication rates among patients completing 14 days of therapy (P<.0001), including 33 (52%) of 64 catheterized and 42 (78%) of 54 noncatheterized patients. Pretreatment serum creatinine levels were inversely related to candiduria eradication. Fluconazole initially produced high eradication rates, but cultures at 2 weeks revealed similar candiduria rates among treated and untreated patients. Oral fluconazole was safe and effective for short-term eradication of candiduria, especially following catheter removal. Long-term eradication rates were disappointing and not associated with clinical benefit.

AB - Management of candiduria is limited by the lack of information about its natural history and lack of data from controlled studies on the efficacy of treating it with antimycotic agents. We compared fungal eradication rates among 316 consecutive candiduric (asymptomatic or minimally symptomatic) hospitalized patients treated with fluconazole (200 mg) or placebo daily for 14 days. In an intent-to-treat analysis, candiduria cleared by day 14 in 79 (50%) of 159 receiving fluconazole and 46 (29%) of 157 receiving placebo (P<.001), with higher eradication rates among patients completing 14 days of therapy (P<.0001), including 33 (52%) of 64 catheterized and 42 (78%) of 54 noncatheterized patients. Pretreatment serum creatinine levels were inversely related to candiduria eradication. Fluconazole initially produced high eradication rates, but cultures at 2 weeks revealed similar candiduria rates among treated and untreated patients. Oral fluconazole was safe and effective for short-term eradication of candiduria, especially following catheter removal. Long-term eradication rates were disappointing and not associated with clinical benefit.

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DO - 10.1086/313580

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SN - 1058-4838

VL - 30

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EP - 24

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 1

ER -

Candiduria: A randomized, double-blind study of treatment with fluconazole and placebo

Abstract

ASJC Scopus subject areas

UN SDGs

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