Prophylactic Fluconazole andCandida kruseiInfections

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Abstract
In the October 31 issue of the Journal, Wingard et al.* reported the results of their retrospective study of the incidence and types of fungal infections in patients who had leukemia or who had undergone bone marrow transplantation. Some of the patients received no antifungal prophylaxis, whereas others received oral fluconazole, intravenous miconazole, or low-dose intravenous amphotericin B. A twofold greater incidence of colonization and a sevenfold greater frequency of infection caused by Candida krusei were noted in the 84 patients who received prophylactic fluconazole as compared with the 335 patients who did not. Nine of the 10 C. krusei infections occurring in 1990 were in recipients of bone marrow transplants. In contrast, the frequency of disseminated C. albicans and C. tropicalis infections tended to be lower in patients receiving prophylactic fluconazole.