Anales del sistema sanitario de Navarra · 2001
[Candidiasis secondary to antibiotic treatment in primary care].
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Tres J C, Urtiaga M
Аннотация
BACKGROUND: At the Pharmacological Vigilance Center of Navarra a prospective observational study was designed and promoted aimed at estimating the incidence of candidiasis and its relation with the consumption of a wide spectrum of antibiotics.
MATERIAL AND METHODS: The field work, which lasted for one week, was carried out with the participation of Primary Care physicians, and included all of the previously selected antibiotic treatments prescribed during that time for any pathology, a search for determinate clinical manifestations, and an evaluation of the existence of a series of predisposing factors.
RESULTS: Of the 1,430 patients treated (by 158 family doctors in 1,098 cases adn by 29 paediatricians in 332 cases) there were 49 cases of localised candidiasis, which gives an incidence of 3.435 (IC 2.61-4.53) The most frequently involved antibiotic group was that of penicillins, with a relative risk of two with respect to the rest of the antibiotics (1.1<RR<3.78) IC95% and, amongst these, the association of clavulanic-amoxycillin showed a relative risk of 3.34 (1.54<RR<7.26) IC95% against the rest of the penicillins.
CONCLUSIONS: It is worth noting the scarce incidence of candidiasis in the paediatric population with just six cases (1.6%), four of them with an oropharyngeal localisation. Bearing in mind that the classical manifestation of this infection in the infant population takes the form of acute pseudomembranous candidiasis, it would not be an exaggeration to think that in this age group, besides the clinical form that has been mentioned, there is a second manifestation in the form of oropharyngeal candidiasis as a secondary effect of antibiotic treatment as an independent entity. Its poor representation is perhaps due to the scarce presence of risk factors in this age group.
MATERIAL AND METHODS: The field work, which lasted for one week, was carried out with the participation of Primary Care physicians, and included all of the previously selected antibiotic treatments prescribed during that time for any pathology, a search for determinate clinical manifestations, and an evaluation of the existence of a series of predisposing factors.
RESULTS: Of the 1,430 patients treated (by 158 family doctors in 1,098 cases adn by 29 paediatricians in 332 cases) there were 49 cases of localised candidiasis, which gives an incidence of 3.435 (IC 2.61-4.53) The most frequently involved antibiotic group was that of penicillins, with a relative risk of two with respect to the rest of the antibiotics (1.1<RR<3.78) IC95% and, amongst these, the association of clavulanic-amoxycillin showed a relative risk of 3.34 (1.54<RR<7.26) IC95% against the rest of the penicillins.
CONCLUSIONS: It is worth noting the scarce incidence of candidiasis in the paediatric population with just six cases (1.6%), four of them with an oropharyngeal localisation. Bearing in mind that the classical manifestation of this infection in the infant population takes the form of acute pseudomembranous candidiasis, it would not be an exaggeration to think that in this age group, besides the clinical form that has been mentioned, there is a second manifestation in the form of oropharyngeal candidiasis as a secondary effect of antibiotic treatment as an independent entity. Its poor representation is perhaps due to the scarce presence of risk factors in this age group.