Eradication of Candida burn wound septicemia in massively burned patients.

The increased incidence of Candida burn wound infection and septicemia in massively burned patients is well known. One thousand thirty six patients were admitted from January 1982 through December 1986. Nystatin prophylaxis, both oral and topical, was initiated in October 1984 and 472 patients were treated. The control group was comprised of the 564 patients treated January 1982 through September 1984. There was a significant difference (p less than 0.005) between the groups in the number of Candida colonized patients, the numbers of Candida burn wound infections, the incidence of multi-organ system involvement/failure, and the occurrence of Candida sepsis. There has not been a Candida burn wound infection in this institution since June 1985. Nystatin, given orally as a 'swish and swallow' or mixed 1:1 with either silver sulfadiazine or polymyxin B/bacitracin, has eradicated Candida burn wound infections and septicemia from this institution and thus obviated the need for systemic antifungals such as amphotericin B.