For a study, researchers sought to find that all consecutive consenting patients with active UC, defined as a Mayo score more or around 3 (CANDIDA), had their stool cultures performed, and predictors for the presence of Candida were identified. In addition to their routine medical care, those who had Candida in their stools were given a placebo or oral fluconazole 200 mg daily for a period of 3 weeks. At baseline and after 4 weeks, the patient’s clinical, sigmoidoscopy, and laboratory data were assessed. The primary outcome was a 4-week clinical and endoscopic response that was assessed as a 3-point decline in Mayo score. Secondary objectives were decreased calprotectin in the feces, a worse histologic response, and unfavorable side effects. Of the 242 people with active UC, 68 (or 28%) had stool cultures that included Candida. In patients with active UC, a partial Mayo score of less than 3 and steroid use were independent predictors of Candida prevalence. Among the 68 patients with Candida on stool culture, 61 participants who met the eligibility criterion were randomly randomized to fluconazole (n=31) or a placebo (n=30). Although the 3-point decline in Mayo score for the fluconazole group was numerically greater than that for the placebo group [5 (16.1% vs. 1 (3.33%); P=0.19], it was not statistically significant. In comparison to the placebo group, [4 (3, 5) vs. 5 (4, 6); P=0.034]. Patients in fluconazole group had more often reduction in fecal calprotectin [26 (83.9%) vs. 11 (36.7%); P=0.001] and histologic scores [23 (74.1%) vs. 10 (33.3%); P=0.001] compared with placebo. All patients were compliant and did not report any serious adverse events.
Source- journals.lww.com
