Which of the following drugs would be appropriate for a systemic antifungal treatment of this patient?
A 68-year-old man is in the hospital because of a prostatectomy performed 4 days
before. He is wearing a urinary catheter and is currently treated with a combination of
broad spectrum antibiotics. The patient has been suffering from chronic renal
insufficiency for the past two years. Two recent urinalysis show many budding yeasts
and cultures were positive for
A. Amphotericin B B. Fluconazole C. Piperacillin D. Metronidazole E. Griseofulvin F. Nystatin
the patient is suffering from candiduria, a condition often related to the placement of an
indwelling urinary catheter, especially if the patient is taking brad spectrum antibiotics, like in
the present case. eradication of candida in the urine includes the removal of the catheter and
an antifungal treatment. treatment options include amphotericin b or fluconazole. however, in
the present patient, amphotericin b, which directly damages renal tubules, is contraindicated
because of chronic renal dysfunction.
a) (see explanation above)
c, d) these agents are not antifungal drugs.
e) this antifungal drug is not effective against candida albicans.
f) nystatin is effective against candida albicans but is too toxic to be used systemically.