Successful Treatment of Fungal Peritonitis in CAPD Using Oral Fluconazole

Venning, M. C.; Ford, Michael T.; Gould, F.K.

doi:10.1093/ndt/5.7.555

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Isolated case reports also exist describing successful treatment with fluconazole alone without catheter removal (20,21). However, the overall cure rate without catheter removal in other, larger series was still very low (8%, Table 4) (3,6,8,10,17,22,23). Only around 50% of patients could continue CAPD with or without catheter removal, similar to the 45% success rate achieved with other antifungal agent combinations according to the review of Cheng et al…”

Section: Treatment and Outcomementioning

confidence: 72%

Fungal Peritonitis -Current Status 1998

Chan

Lui

et al. 1999

Perit Dial Int

View full text Add to dashboard Cite

Section: Treatment and Outcomementioning

confidence: 72%

Fungal Peritonitis -Current Status 1998

Chan

Lui

et al. 1999

Perit Dial Int

View full text Add to dashboard Cite

“…Reported cases of FP treated with fluconazole-fluorocytosine are still few at present [24,29,[32][33][34][35][36][37][38][39] (table 4). In our opinion, unduly hopes should not be placed in this combination, and the clinical course should be cautiously monitored in order to enable catheter removal in time, if clinical or bacteriological responses are not rapidly seen with this treatment and in cases of filamentous fungi.…”

Section: Discussionmentioning

confidence: 99%

Fungal Peritonitis in Patients on Peritoneal Dialysis

et al. 1994

View full text Add to dashboard Cite

Fungal peritonitis (FP) is a serious complication of peritoneal dialysis, both in terms of morbidity and mortality. Available data on the effectiveness of fluconazole in eradicating FP without catheter removal are still controversial. We reviewed 20 FP cases that occurred among 325 patients who underwent peritoneal dialysis in our center between January 1984 and January 1992, in order to establish whether a profile of patients at risk of developing FP could be identified and to evaluate the effectiveness of fluconazole in treating FP (7 cases). Age, sex, a particular cause of end-stage renal disease, and the presence of diabetes did not correlate significantly with the development of FP. The risk of FP increased in patients on immunosuppressive treatment. Sixteen of our 20 patients had bacterial peritonitis during the month before they developed FP. Nineteen were treated with antibiotics. Neither the type of bacterial organism isolated during the bacterial peritonitis preceding FP nor modality and duration of antibiotic treatment correlated significantly with the development of FP. Patients who subsequently developed FP were more frequently treated with antibiotics while in hospital (p < 0.001). Candida species accounted for 15 of our 20 FP cases (75 %), with Candida albicans being by far the most common isolate. Treatment strategies varied among the 20 patients. The combination of intravenous or intraperitoneal administration of 5-fluoro-cytosine and oral administration of fluconazole was used in 7 cases: only 1 patient was cured without catheter removal, 1 patient died within the first 4 days of treatment, removal of peritoneal catheter was necessary in the other 5 patients. The main risk factors for the development of FP are a recent episode of bacterial peritonitis and recent exposure to antibiotics, especially when antibiotics were administered while in hospital. Under these circumstances, prophylactic administration of fluconazole should be considered. Despite initially favorable reports, fluconazole does not avoid the need for catheter removal to eradicate FP in most cases.

show abstract