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Editor's Correspondence |

Fluconazole and Candida krusei Fungemia

Corrado Girmenia, MD; Livio Pagano, MD; Giuseppe Leone, MD; Pietro Martino, MD
Arch Intern Med. 2001;161(18):2269-2270. doi:.
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In their series on Candida krusei fungemia occurring at The University of Texas M. D. Anderson Cancer Center, Houston, from 1989 to 1996, Abbas et al1 observed an escalating frequency of this complication in patients with hematologic malignancies since 1993, when fluconazole became widely used as a prophylactic agent. These data confirm the association between fluconazole use and infections caused by this fungus that was previously reported at The University of Texas M. D. Anderson Cancer Center.2 However, this epidemiologic phenomenon continues to be debated, as other authors have not observed an impact of fluconazole use on the etiology of Candida infections, and the proportion of patients with cancer and candidemia due to C krusei seems not to have varied over the past 2 decades.39 Importantly, the emergence of C krusei infections in association with fluconazole prophylaxis has been noted only at single centers,1,1013 in contrast with the findings in multicenter trials.35

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Use of oral and intravenous fluconazole and number of Candida krusei fungemia episodes at the Dipartimento di Biotecnologie Cellulari ed Ematologia, University "La Sapienza" (A), and the Istituto di Semeiotica Medica, University Cattolica del Sacro Cuore (B), Rome, Italy.

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