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. 1996 Feb;40(2):494–496. doi: 10.1128/aac.40.2.494

Comparison of fluconazole and amphotericin B in prophylaxis of experimental Candida endocarditis caused by non-C. albicans strains.

A S Bayer 1, M D Witt 1, E Kim 1, M A Ghannoum 1
PMCID: PMC163144  PMID: 8834908

Abstract

Amphotericin B (1 mg/kg of body weight, intravenous) and fluconazole (100 mg/kg, intraperitoneal) were compared in the prophylaxis of experimental Candida endocarditis caused by drug-susceptible, non-C. albicans strains C. tropicalis and C. parapsilosis. Neither antifungal agent was effective at preventing endocarditis due to either Candida strain when either agent was administered in a single-dose regimen (1 h prior to fungal challenge); the prophylactic efficacy of both agents increased substantially when a second prophylactic dose was given (24 h postchallenge). The excellent prophylactic efficacy of fluconazole, a fungistatic agent, underscores the importance of microbistatic mechanisms in endocarditis prophylaxis.

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Selected References

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  1. Bayer A. S., Tu J. Chemoprophylactic efficacy against experimental endocarditis caused by beta-lactamase-producing, aminoglycoside-resistant enterococci is associated with prolonged serum inhibitory activity. Antimicrob Agents Chemother. 1990 Jun;34(6):1068–1074. doi: 10.1128/aac.34.6.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bayer A. S., Yih J., Chiu C. Y., Nast C. C. Pathogenic effects of monocytopenia, granulocytopenia and dexamethasone on the course of experimental Pseudomonas aeruginosa endocarditis in rabbits. Chemotherapy. 1989;35(4):278–288. doi: 10.1159/000238683. [DOI] [PubMed] [Google Scholar]
  3. Berney P., Francioli P. Successful prophylaxis of experimental streptococcal endocarditis with single-dose amoxicillin administered after bacterial challenge. J Infect Dis. 1990 Feb;161(2):281–285. doi: 10.1093/infdis/161.2.281. [DOI] [PubMed] [Google Scholar]
  4. Como J. A., Dismukes W. E. Oral azole drugs as systemic antifungal therapy. N Engl J Med. 1994 Jan 27;330(4):263–272. doi: 10.1056/NEJM199401273300407. [DOI] [PubMed] [Google Scholar]
  5. Dajani A. S., Bisno A. L., Chung K. J., Durack D. T., Freed M., Gerber M. A., Karchmer A. W., Millard H. D., Rahimtoola S., Shulman S. T. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA. 1990 Dec 12;264(22):2919–2922. [PubMed] [Google Scholar]
  6. DeMuria D., Forrest A., Rich J., Scavone J. M., Cohen L. G., Kazanjian P. H. Pharmacokinetics and bioavailability of fluconazole in patients with AIDS. Antimicrob Agents Chemother. 1993 Oct;37(10):2187–2192. doi: 10.1128/aac.37.10.2187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Doscher W., Krishnasastry K. V., Deckoff S. L. Fungal graft infections: case report and review of the literature. J Vasc Surg. 1987 Oct;6(4):398–402. doi: 10.1067/mva.1987.avs0060398. [DOI] [PubMed] [Google Scholar]
  8. Fluckiger U., Francioli P., Blaser J., Glauser M. P., Moreillon P. Role of amoxicillin serum levels for successful prophylaxis of experimental endocarditis due to tolerant streptococci. J Infect Dis. 1994 Jun;169(6):1397–1400. doi: 10.1093/infdis/169.6.1397. [DOI] [PubMed] [Google Scholar]
  9. Gallis H. A., Drew R. H., Pickard W. W. Amphotericin B: 30 years of clinical experience. Rev Infect Dis. 1990 Mar-Apr;12(2):308–329. doi: 10.1093/clinids/12.2.308. [DOI] [PubMed] [Google Scholar]
  10. Glauser M. P., Bernard J. P., Moreillon P., Francioli P. Successful single-dose amoxicillin prophylaxis against experimental streptococcal endocarditis: evidence for two mechanisms of protection. J Infect Dis. 1983 Mar;147(3):568–575. doi: 10.1093/infdis/147.3.568. [DOI] [PubMed] [Google Scholar]
  11. Goodman J. L., Winston D. J., Greenfield R. A., Chandrasekar P. H., Fox B., Kaizer H., Shadduck R. K., Shea T. C., Stiff P., Friedman D. J. A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. N Engl J Med. 1992 Mar 26;326(13):845–851. doi: 10.1056/NEJM199203263261301. [DOI] [PubMed] [Google Scholar]
  12. Harvey R. L., Myers J. P. Nosocomial fungemia in a large community teaching hospital. Arch Intern Med. 1987 Dec;147(12):2117–2120. [PubMed] [Google Scholar]
  13. Komshian S. V., Uwaydah A. K., Sobel J. D., Crane L. R. Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics, and evaluation of factors influencing outcome. Rev Infect Dis. 1989 May-Jun;11(3):379–390. doi: 10.1093/clinids/11.3.379. [DOI] [PubMed] [Google Scholar]
  14. Powderly W. G., Finkelstein D., Feinberg J., Frame P., He W., van der Horst C., Koletar S. L., Eyster M. E., Carey J., Waskin H. A randomized trial comparing fluconazole with clotrimazole troches for the prevention of fungal infections in patients with advanced human immunodeficiency virus infection. NIAID AIDS Clinical Trials Group. N Engl J Med. 1995 Mar 16;332(11):700–705. doi: 10.1056/NEJM199503163321102. [DOI] [PubMed] [Google Scholar]
  15. Rex J. H., Bennett J. E., Sugar A. M., Pappas P. G., van der Horst C. M., Edwards J. E., Washburn R. G., Scheld W. M., Karchmer A. W., Dine A. P. A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. N Engl J Med. 1994 Nov 17;331(20):1325–1330. doi: 10.1056/NEJM199411173312001. [DOI] [PubMed] [Google Scholar]
  16. Rotrosen D., Calderone R. A., Edwards J. E., Jr Adherence of Candida species to host tissues and plastic surfaces. Rev Infect Dis. 1986 Jan-Feb;8(1):73–85. doi: 10.1093/clinids/8.1.73. [DOI] [PubMed] [Google Scholar]
  17. Rotrosen D., Gibson T. R., Edwards J. E., Jr Adherence of candida species to intravenous catheters. J Infect Dis. 1983 Mar;147(3):594–594. doi: 10.1093/infdis/147.3.594. [DOI] [PubMed] [Google Scholar]
  18. Saag M. S., Dismukes W. E. Azole antifungal agents: emphasis on new triazoles. Antimicrob Agents Chemother. 1988 Jan;32(1):1–8. doi: 10.1128/aac.32.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sanchez V., Vazquez J. A., Barth-Jones D., Dembry L., Sobel J. D., Zervos M. J. Nosocomial acquisition of Candida parapsilosis: an epidemiologic study. Am J Med. 1993 Jun;94(6):577–582. doi: 10.1016/0002-9343(93)90207-6. [DOI] [PubMed] [Google Scholar]
  20. Stevens D. A., Greene S. I., Lang O. S. Thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. Randomized, double-blind, placebo-controlled study of 100-mg oral fluconazole daily. Arch Intern Med. 1991 Dec;151(12):2458–2464. [PubMed] [Google Scholar]
  21. Walsh T. J., Pizzo A. Treatment of systemic fungal infections: recent progress and current problems. Eur J Clin Microbiol Infect Dis. 1988 Aug;7(4):460–475. doi: 10.1007/BF01962595. [DOI] [PubMed] [Google Scholar]
  22. Wey S. B., Mori M., Pfaller M. A., Woolson R. F., Wenzel R. P. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med. 1988 Dec;148(12):2642–2645. doi: 10.1001/archinte.148.12.2642. [DOI] [PubMed] [Google Scholar]
  23. Wingard J. R., Merz W. G., Saral R. Candida tropicalis: a major pathogen in immunocompromised patients. Ann Intern Med. 1979 Oct;91(4):539–543. doi: 10.7326/0003-4819-91-4-539. [DOI] [PubMed] [Google Scholar]
  24. Winston D. J., Chandrasekar P. H., Lazarus H. M., Goodman J. L., Silber J. L., Horowitz H., Shadduck R. K., Rosenfeld C. S., Ho W. G., Islam M. Z. Fluconazole prophylaxis of fungal infections in patients with acute leukemia. Results of a randomized placebo-controlled, double-blind, multicenter trial. Ann Intern Med. 1993 Apr 1;118(7):495–503. doi: 10.7326/0003-4819-118-7-199304010-00003. [DOI] [PubMed] [Google Scholar]
  25. Witt M. D., Bayer A. S. Comparison of fluconazole and amphotericin B for prevention and treatment of experimental Candida endocarditis. Antimicrob Agents Chemother. 1991 Dec;35(12):2481–2485. doi: 10.1128/aac.35.12.2481. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Witt M. D., Imhoff T., Li C., Bayer A. S. Comparison of fluconazole and amphotericin B for treatment of experimental Candida endocarditis caused by non-C. albicans strains. Antimicrob Agents Chemother. 1993 Sep;37(9):2030–2032. doi: 10.1128/aac.37.9.2030. [DOI] [PMC free article] [PubMed] [Google Scholar]

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