Control of systemic spread of Candida albicans with ketoconazole in the stomachs of mice treated with cytarabine.

Attempts were made to colonize the gastrointestinal tract of outbred CD-1 mice with Candida albicans or Candida tropicalis before assessing the effects of cytarabine and ketoconazole on colonization. Stable populations of C. albicans but not C. tropicalis could be maintained in the stomachs of mice infected as adults if they were maintained on penicillin and tetracycline, or in untreated mice if the fungus was administered while they were infants. Treatment with cytarabine of mice colonized with C. albicans resulted in increased levels of yeast in the stomach, and small numbers of yeasts were recovered from the livers, kidneys, and spleens. Ketoconazole limited the multiplication of the yeast in the stomachs of colonized mice, although the effect was somewhat variable. Systemic spread of the fungus was essentially eliminated in animals receiving both ketoconazole and cytarabine, suggesting that ketoconazole may be an appropriate prophylactic agent for individuals undergoing therapy with cytarabine.