Management of Candida Urinary Tract Infection in the Elderly

Sang Jin Kim; Jae Hyun Ryu; Yun Beom Kim; Seung Ok Yang

doi:10.14777/uti.2019.14.2.33

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Review Management of Candida Urinary Tract Infection in the Elderly: Sang Jin Kim, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang; Urogenital Tract Infection 2019;14(2):33-41.
DOI: https://doi.org/10.14777/uti.2019.14.2.33
Published online: August 30, 2019

Department of Urology, Veterans Health Service Medical Center, Seoul, Korea

Received: 23 April 2019 • Revised: 10 May 2019 • Accepted: 10 May 2019

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Abstract

Candida urinary tract infections in elderly patients are becoming increasingly common. The risk factors for the development of candiduria include old age, use of broad-spectrum antibiotics, corticosteroids and indwelling urethral catheters, as well as diabetes mellitus, urological abnormalities, and hematological malignancies. The presence of signs and symptoms of infection are unusual, and the intensity of fungal growth in culture does not correlate with the outcome. Elderly patients often present with atypical signs and symptoms of infection. Careful assessment of the patient’s clinical status should be undertaken before treatment is initiated. The indications for antifungal therapy are the same for older and younger individuals, and the initial antifungal therapy should be selected based on the infecting organism and local epidemiology. Fluconazole is the mainstay of treatment. On the other hand, Candida glabrata is more common in elderly patients and is often refractory to fluconazole therapy. The selection of drug therapy for elderly patients should consider the comorbidities, risk of drug-drug interactions, and dose adjustment for physiological function.

Keywords: Candida; Disease management; Frail elderly; Urinary tract infections

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Management of Candida Urinary Tract Infection in the Elderly

Urogenit Tract Infect. 2019;14(2):33-41. Published online August 30, 2019

DOI: https://doi.org/10.14777/uti.2019.14.2.33