Fluconazole prophylaxis in critically ill trauma intensive care unit patients

Introduction: To investigate the efficacy of fluconazote as prophylaxis on the incidence of secondary fungal infections in critically ill trauma intensive care unit (TICU) patients receiving broad spectrum antibiotics and to assess the development of resistant fungal species to fluconazote Methods: Descriptive, prospective study, over 38 months, involving 328 TICU patients placed on broad spectrum antibiotics. AI patients received 200 mg/day enterai dose fluconazote for the duration of broad spectrum antibiotic usage. Pre-and post-fluconazole cultures are obtained. Results: 328 TICU patients were placed on broad spectrum antibiotics and subsequent floconazote prophylaxis. Distribution of fungal species while on fluconazote prophylaxis: Site C. albkans Non-C. a/ftcans Total blood 3 9 12 tracheal 5 13 18 urine 2 22 24 other 3 13 16 Total 13 57 70 12 patients developed fungemia. Non-Candfcte a/beans organisms accounted for over four times as many candidat infections. Conclusion: Fluconazote. at 200mg/day, for TICU patients receiving broad spectrum antibiotics, did not prevent the development of fungemia. Fungal species which developed were T. giabrata, C. tropicatis, and C. parapsetosis and not C. Krusei.