氟康唑预防留置导尿管病人的尿路真菌感染

目的：研究氟康唑对重症监护室（ Ｉ Ｃ Ｕ） 病人尿路真菌感染的预防作用。方法：留置导尿的颅脑外伤和脑血管意外病人１３０ 例分为３ 组：对照组（４２例） ，不给抗真菌药物；氟康唑５０ ｍ ｇ 组（４９ 例） ，用氟康唑５０ ｍｇ ，ｑｄ ， 始于置管后（２ ．８ ±１ ．２） ｄ ； 氟康唑１００ ｍｇ 组（３９ 例） ，用１００ ｍ ｇ ，ｑｄ ， 始于置管后（２ ．７ ±１ ．３） ｄ 。氟康唑均由胃管注入或口服。每周作１ 次尿真菌培养等检查。结果：对照组ｗ ｋ １ ，２ ，３ 尿路真菌感染率分别为６２ ％ ，８３ ％ 和８５ ％ ；氟康唑５０ ｍｇ 组分别为４３ ％ ，３５ ％ 和１４ ％ 。１００ ｍｇ 组分别为３６ ％ ，２９ ％ 和２２ ％ 。２ 用药组ｗｋ ２ ， ３ 的感染率显著降低（ Ｐ＜ ０ ．０１） 。结论：氟康唑（５０ ｍ ｇ 或１００ ｍｇ ，ｑｄ） 能安全有效地预防 Ｉ Ｃ Ｕ 病人尿路真菌感染。

Fluconazole prevented urinary tract fungal infection during prolonged urinary catheterization

AIM: To study the prophylactic effect of fluconazole on the urinary tract fungal infection in the intensive care unit (ICU) patients. METHODS: One hundred and thirty patients suffering from head injuries and cerebrovascular accidents and with indwelling urethral catheters were divided into 3 groups: (1)control (42 patients), no antifungals were given; (2)fluconazole 50 mg qd (49 patients), started (2.8±1.2) d after catheterization; (3)fluconazole 100 mg qd ( 39 patients) , started ( 2.7 ± 1.3) d after catheterization. Fluconazole was administered via nasogastric tube or orally. Examinations such as urine culture for fungus were performed once a week. RESULTS: The percentages of urinary tract fungal infection at wk 1, 2 and 3 were 62%, 83% and 85%, respectively, in the control group; 43%, 35% and 14% in the fluconazole 50 mg group; 36%, 29% and 22% in the fluconazole 100 mg group. The rates of infection in both fluconazole groups at wk 2 and 3 were significantly reduced (P<0.01). A small number of patients taking fluconazole developed mild gastrointestinal adverse reactions or changes in liver function. CONCLUSION: Fluconazole (50 mg or 100 mg qd) is efficacious and safe for the prophylaxis against urinary tract fungal infection in the ICU patients. There is no marked difference between the effects of the two dosage schedules.