[Reduction of the risk of endomycosis in patients with prolonged endotracheal intubation using local antimycotic prophylaxis].

The Candida colonization and the dynamics of antibodies to Candida were studied in intensive care patients. 20 patients received no antifungal prophylaxis, 20 patients were treated by local application of Pimaricin into the mouth, nose, and into the respiratory tract during the time of intratracheal intubation. The frequencies and quantities of yeasts in the respiratory secretions were considerably reduced in the group receiving Pimaricin, whereas the amount of faecal colonization showed no difference between both groups of patients. During the 2nd-3rd week of hospitalization 17 patients of the untreated group and 4 patients of the treated group developed a significant rise of Candida antibodies. The association between the respiratory colonization and the antibody response indicates that the mucosa of the mouth and the respiratory tract is a main source of Candida invasion. In order to prevent that precondition of Candida endomycosis, routine ororespiratory antifungal prophylaxis is recommended, particularly in patients with prolonged intratracheal intubation.