expert, from Europe ():
Fungal prophylaxis using oral nystatin or fluconazole during antibiotic therapy may prevent some cases of Candida peritonitis in programs that have high rates of fungal peritonitis. Nystatin tablets (500,000 units, 4 times per day) can be given orally to cover the whole course of antibiotic therapy (Wong et al, PDI 2007). To my knowledge, there is no clear superiority of nystatin or fluconazole in the prevention of fungal peritonitis. There is no evidence that fungal prophylaxis during antibiotherapy for PD-related peritonitis can reduce the rate of fungal peritonitis in programs with low baseline rate of FP.
Expert C, from (United States):
There are clinical trials that have shown that nystatin is superior to placebo and that fluconazole is superior to placebo when using antibiotics for longer than five days. Given the low overall risk with the use of nystatin and the extremely high risk of adverse consequences with the occurrence of fungal peritonitis, we routinely prescribe nystatin every time a patient is treated with antibiotics for longer than five days for whatever be the site of infection (PD-related peritonitis or diabetic foot or pneumonia).
Expert B, from (Australia):
We prescribe Nystatin tablets 500,000 units qid for the length of the antibiotic course plus 7 days after the antibiotic course is completed.
