Treatment of disseminated candidiasis with 5-fluorocytosine.
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In 11 patients with disseminated candidiasis, 5-fluorocytosine (5FC) was administered iv or orally in an initial dosage of 150-200 mg/kg per day. The dose was then adjusted according to renal function and serum levels of 5FC. Therapy was maintained for an average of 31 days, with a mean total dose of 284 g. During therapy Candida disappeared from the blood in all cases. In three patients resistance to 5FC was observed in fungi isolated from sources other than blood. The clinical response to 5FC was characterized by a slow fall in temperature during the first two weeks after the start of therapy. The therapy was successful in 10 patients. In one case cerebral abscesses due to Candida were found on necropsy. No severe side effects of 5FC were observed. The presence of Candida in blood cultures from a patient does not always indicate an established
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