The Use of Fluconazole as a Local Irrigant for Nephrostomy Tubes

Clark, Max A.; Gaunt, Tina; Czachor, John S.

doi:10.1093/milmed/164.3.239

Cited by 11 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another important issue in the management of pyonephrosis is the accumulation of pus and fungi in an obstructed space, the renal pelvices. As with other enclosed bacterial infections such as empyemas, drainage of the pus is of fundamental importance and may explain why systemic treatment with antifungals such as amphotericin B, caspofungin or fluconazole alone have proven to be unsuccessful [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Limitations of caspofungin in the treatment of obstructive pyonephrosis due to Candida glabrata infection

Schelenz

Ross

2006

BMC Infect Dis

View full text Add to dashboard Cite

Background: Caspofungin is a new antifungal agent with high-level activity against a number of Candida species including those that are resistant to azoles. Its good safety profile and low nephrotoxicity makes it an attractive drug to treat fungal infections in patients with compromised renal function. However, little is known about the clinical efficacy in the treatment of complicated urinary tract infections due to Candida species such as pyonephrosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Limitations of caspofungin in the treatment of obstructive pyonephrosis due to Candida glabrata infection

Schelenz

Ross

2006

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…8 Treatment with combination systemic antifungal agents has been successful in children, 9 as has topical antifungal irrigation. [10][11][12] When the kidney is obstructed, it must be drained to preserve renal function. Conventional 8F to 10F nephrostomy tubes are often inadequate for the drainage of such thick material as is seen in candidal infection.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Renal Candidiasis

Chitale

Shaida

Burtt

et al. 2004

Journal of Endourology

View full text Add to dashboard Cite

Renal candidial infections have been described in the literature in susceptible populations of all age groups. Systemic antifungal agents have been successful in treating these patients, but in the presence of an obstructed kidney, antegrade (perurethral) or retrograde (percutaneous) drainage of the pelvicaliceal system is mandatory to salvage the kidney. An aggressive percutaneous endoscopic approach for the management of such a case in a young diabetic patient with multiple comorbidities is described here with initial success.

show abstract

“…In addition to amphotericin B, fluconazole has also been described in the literature as an irrigation for nephrostomy tubes to treat upper urinary tract C. albicans infections [81][82][83][84]. Two case reports exist describing this therapy and in both cases prior and concomitant systemic fluconazole therapy was reported [81,82].…”

Section: Fluconazolementioning

confidence: 99%

“…Two case reports exist describing this therapy and in both cases prior and concomitant systemic fluconazole therapy was reported [81,82]. In one case, fluconazole 10 mg was added to 1 litre of normal saline and infused over 12 h [81].…”

Section: Fluconazolementioning

confidence: 99%

See 1 more Smart Citation

Novel modes of antifungal drug administration

Arthur¹,

Drew²,

Perfect³

2004

Expert Opinion on Investigational Drugs

View full text Add to dashboard Cite

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.

show abstract

The Use of Fluconazole as a Local Irrigant for Nephrostomy Tubes

Cited by 11 publications

References 0 publications

Limitations of caspofungin in the treatment of obstructive pyonephrosis due to Candida glabrata infection

Limitations of caspofungin in the treatment of obstructive pyonephrosis due to Candida glabrata infection

Endoscopic Management of Renal Candidiasis

Novel modes of antifungal drug administration

Contact Info

Product

Resources

About