Bladder irrigation with amphotericin B and fungal urinary tract infection-systematic review with meta-analysis

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dc.contributor.authorTuon F.F.
dc.contributor.authorAmato V.S.
dc.contributor.authorFilho S.R.P.
dc.date.accessioned2024-03-13T01:34:04Z
dc.date.available2024-03-13T01:34:04Z
dc.date.issued2009
dc.description.abstractBackground: Candiduria is a hospital-associated infection and a daily problem in the intensive care unit. The treatment of asymptomatic candiduria is not well established and the use of amphotericin B bladder irrigation (ABBI) is controversial. The aim of this systematic review was to determine the best place for this therapy in practice. Methods: The databases searched in this study included MEDLINE, EMBASE, Web of Science, and LILACS (January 1960-June 2007). We included manuscripts with data on the treatment of candiduria using ABBI. The studies were classified as comparative, dose-finding, or non-comparative. Results: From 213 studies, nine articles (377 patients) met our inclusion criteria. ABBI showed a higher clearance of the candiduria 24 hours after the end of therapy than fluconazole (odds ratio (OR) 0.57, 95% confidence interval (CI) 0.32-1.00). Fungal culture 5 days after the end of both therapies showed a similar response (OR 1.51, 95% CI 0.81-2.80). The evaluation of ABBI using an intermittent or continuous system of delivery showed an early candiduria clearance (24 hours after therapy) of 80% and 82%, respectively (OR 0.87, 95% CI 0.52-1.36). Candiduria clearance at >5 days after the therapy showed a superior response using continuous bladder irrigation with amphotericin B (OR 0.52, 95% CI 0.29-0.94). The use of continuous ABBI for more than 5 days showed a better result (88% vs. 78%) than ABBI for less than 5 days, but without significance (OR 0.55, 95% CI 0.34-1.04). Conclusion: Although the strength of the results in the underlying literature is not sufficient to allow the drawing of definitive conclusions, ABBI appears to be as effective as fluconazole, but it does not offer systemic antifungal therapy and should only be used for asymptomatic candiduria. © 2008 International Society for Infectious Diseases.
dc.description.firstpage701
dc.description.issuenumber6
dc.description.lastpage706
dc.description.volume13
dc.identifier.doi10.1016/j.ijid.2008.10.012
dc.identifier.issn1201-9712
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/37325
dc.relation.ispartofInternational Journal of Infectious Diseases
dc.rightsAcesso Aberto
dc.subject.otherlanguageAmphotericin B
dc.subject.otherlanguageBladder
dc.subject.otherlanguageCandida
dc.subject.otherlanguageCandiduria
dc.subject.otherlanguageFunguria
dc.subject.otherlanguageUrinary tract infection
dc.titleBladder irrigation with amphotericin B and fungal urinary tract infection-systematic review with meta-analysis
dc.typeArtigo
local.scopus.citations31
local.scopus.eid2-s2.0-70449120298
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=70449120298&origin=inward
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