A randomized, blinded, multicenter trial was conducted to compare fluconazole (800 mg per day) plus placebo with fluconazole plus amphotericin B (AmB) deoxycholate (0.7 mg/kg per day, with the placebo/AmB component given only for the first 5-6 days) as therapy for candidemia due to species other than Candida krusei in adults without neutropenia. A total of 219 patients met criteria for a modified intent-to-treat analysis. The groups were similar except that those who were treated with fluconazole plus placebo had a higher mean (+/- standard error) Acute Physiology and Chronic Health Evaluation II score (16.8+/-0.6 vs. 15.0+/-0.7; P=.039). Success rates on study day 30 by Kaplan-Meier time-to-failure analysis were 57% for fluconazole plus placebo and 69% for fluconazole plus AmB (P=.08). Overall success rates were 56% (60 of 107 patients) and 69% (77 of 112 patients; P=.043), respectively; the bloodstream infection failed to clear in 17% and 6% of subjects, respectively (P=.02). In nonneutropenic subjects, the combination of fluconazole plus AmB was not antagonistic compared with fluconazole alone, and the combination trended toward improved success and more-rapid clearance from the bloodstream.

In this study, OspA vaccine was safe and effective in the prevention of Lyme disease.

Traveler's diarrhea can be a debilitating problem for individuals on international trips. Retrospective and prospective studies have shown the incidence of traveler's diarrhea to range from 15-56%. 1,2A placebo-controlled, double-blinded study in Finnish travelers found that the probiotic Lactobacillus GG decreases the incidence of traveler's diarrhea.3 Lactobacillus GG, initially isolated from healthy humans, is remarkable in its ability to resist acid and bile degradation and to adhere to the intestinal mucosa.4 To assess the efficacy of Lactobacillus GG in preventing diarrhea in American tourists, a study was conducted at the Travel and Immunization Center of the Long Island Jewish Medical Center (LIJMC).