Fungal infection in burn patients: Results of using 5-fluorocytosine (flucytosine)

Abstract

Fungal infection and use of 5-fluorocytosine were studied prospectively among burn patients receiving multiple antibiotics. From 22 out of 23 patients positive cultures for Candida were obtained. Cultures from the mouth and rectum became positive first. Averaging 6 days later, 16 patients had positive urine cultures. Candida in urine was the best way to detect systemic candidiasis. Nine patients received 5-fluorocytosine. Although this drug did not influence survival among patients with burns of less than 59 per cent of body surface area, it prevented death from disseminated Candida infection among patients with burns of greater than 60 per cent body surface area. Patients with large surface burns receiving multiple antibiotics should have prophylaxis against fungi. If Candida is detected in urine, systemic treatment should be given. 5-Fluorocytosine is a safe and effective systemic drug for this purpose.