Amphotericin B Lavage in the Treatment of Candidial Cystitis

Cuetara, Marisol; Mallo, N; Dalet, F

doi:10.1111/j.1464-410x.1972.tb10109.x

Cited by 19 publications

(6 citation statements)

References 8 publications

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“…Subsequent to this report, numerous case reports [5,[50][51][52][53][54], uncontrolled trials [55,56], retrospective case series with historical controls [57] and prospective, controlled clinical studies [58][59][60][61] have described the potential role of amphotericin B bladder washes in the treatment of funguria. Additional details regarding these studies can be found in Table 3.…”

Section: Amphotericin Bmentioning

confidence: 97%

“…In some cases, the urinary catheter had been clamped and the irrigation solution allowed to dwell for a period of 2 -3 h [51,63]. Daily doses in these reports range from 5 to 50 mg, usually administered once-daily [5,[50][51][52]55,56,58]. In one report, intermittent therapy was repeated three times daily [59,63].…”

Section: Amphotericin Bmentioning

confidence: 98%

“…Administration has ranged from intermittent instillation [5,62] to continuous irrigations (usually via three-way foley catheter) [50,52,[55][56][57][58]62]. In some cases, the urinary catheter had been clamped and the irrigation solution allowed to dwell for a period of 2 -3 h [51,63]. Daily doses in these reports range from 5 to 50 mg, usually administered once-daily [5,[50][51][52]55,56,58].…”

Section: Amphotericin Bmentioning

confidence: 99%

“…Efficacy rates for amphotericin B bladder irrigations vary widely in the literature but range from 43 -100% [5, [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64]. Clinical trials have also compared the efficacy of amphotericin B bladder washes to treatments, such as oral fluconazole [58][59][60][61], intravenous amphotericin B [61] and no treatment [59,61].…”

Section: Type Of Study Treatment Number Of Patients Patient Populatiomentioning

confidence: 99%

“…The total daily dose has been dissolved in diluents, including 20 -1000 ml of sterile water [5,[51][52][53]55,56,58,62,63,65] or D5W [50,57,59,60,66]. Amphotericin B bladder washes must be protected from light and heat.…”

Section: Article Type Of Study Treatment Number Of Patients Patient Pmentioning

confidence: 99%

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Novel modes of antifungal drug administration

Arthur¹,

Drew²,

Perfect³

2004

Expert Opinion on Investigational Drugs

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Administration of antifungals by routes other than that for which the agent was designed or approved have been utilised in attempts to provide directed therapy, reduce adverse effects and improve drug penetration into selected infection sites, such as the central nervous system, lungs and peritoneum. The most widely investigated agent utilising a novel method of drug delivery is amphotericin B. Dose forms for this agent include topicals (aerosol, nasal spray, irrigations, pastes, absorbable sponges, impregnated bone cement and gelatin), oral dosage forms (solutions, suspensions, tablets and so on) and ophthalmic preparations (drops, ointments and injections). Amphotericin B has been administered by routes such as oral, endobronchial, intrathecal, intracisternal, intra-articular, intraperitoneal, ophthalmic and as an antibiotic 'line lock'. Nystatin has been administered as an aerosol, percutaneous paste and bladder washes. Azoles, such as miconazole, fluconazole, ketoconazole and posaconazole, have been administered by novel methods but to a lesser degree. Most of these reports involve miconazole. The dose forms and routes of administration for azoles have included irrigants (bladder, joint), ophthalmic preparations (eye drops, intraocular injections, ointments), impregnated bone cement, endobronchial and intrathecal administration. Finally, both methylene blue (bladder washes) and flucytosine (peritoneal lavage, ophthalmic eye drops) have also been employed. Adequate evaluations of both the safety and efficacy of these therapies are most often hindered by prior or concomitant antifungal therapies, comorbidities and the lack of controlled clinical trials. In addition, the availability of newer treatment options, which demonstrate significant improvement in drug distribution and treatment-related adverse effects make many such novel modes of administration less practical or necessary. In contrast, the inhalation of antifungal aerosols, such as amphotericin B, is rapidly becoming a viable prophylactic option.

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Section: Amphotericin Bmentioning

confidence: 97%

Section: Amphotericin Bmentioning

confidence: 98%

Section: Amphotericin Bmentioning

confidence: 99%

Section: Type Of Study Treatment Number Of Patients Patient Populatiomentioning

confidence: 99%

Section: Article Type Of Study Treatment Number Of Patients Patient Pmentioning

confidence: 99%

See 3 more Smart Citations

Novel modes of antifungal drug administration

Arthur¹,

Drew²,

Perfect³

2004

Expert Opinion on Investigational Drugs

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Treatment of Funguria

Wong-Beringer

Jacobs²,

Guglielmo³

1992

JAMA

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We evaluated the use of antifungal agents in the treatment of uncomplicated funguria by reviewing all case reports and studies regarding the treatment of funguria published in the English language from 1960 to 1991 (MEDLINE). Adult patients treated for uncomplicated funguria were included. Patients with fungal pyelonephritis and/or other systemic fungal manifestations were excluded from our analysis. All investigations were assessed for study design, sample size, definition of significant funguria, treatment regimen, inclusion of predisposing risk factors in outcome analysis, end points of therapy, and patient follow-up. Direct comparison of the studies on the use of antifungals in the treatment of uncomplicated funguria was not possible given the differing definitions of significant funguria, inconsistent reporting of risk factors, varying treatment regimens, end points of therapy, and duration of follow-up. Case reports and studies involving antifungals such as amphotericin B bladder irrigation, miconazole nitrate bladder irrigation, ketoconazole, and flucytosine were reviewed. Amphotericin B bladder irrigation appeared to be most effective and ketoconazole the least effective treatment of uncomplicated funguria. Predisposing risk factors, such as the presence of an indwelling urinary catheter, appear to play an important role in the persistence of positive cultures and failure of pharmacologic interventions. Until prospective, well-controlled studies are performed, no recommendation can be made for the treatment of uncomplicated funguria. In symptomatic patients therapy is indicated; however, the best regimen is unknown.

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