Pathogenesis of Candida Albicans Infection following Antibiotic Therapy

One of the complications which may be encountered during the course of therapy with antibiotics is the development of secondary infections superimposed upon the condition being treated. These superimposed infections are caused by microorganisms resistant to the original treatment and, when a fungus is responsible for the new infection, the problem becomes particularly distressing because of the general lack of satisfactory therapeutic measures for management of mycotic disease. It is obvious that an understanding of the biologic phenomena responsible for the development of these superinfections would lead toward a more rational approach to antibiotic therapy. One of the theories offered in explanation of this problem states that the antibiotics directly stimulate the fungus. Since candidiasis is one of the more frequent mycotic complications encountered, much of the reported work in this area of interest is concerned with the effect of the antibiotics on Candida albicans, and here the evidence is conflicting. The studies of some investigators would indicate that at least one of the more common antibiotics does stimulate the growth and virulence of C. albicans, while others have been unable to demonstrate this effect (Foley and Winter, 1949; Hazen et al., 1953; Kligman, 1952; Lipnik et al., 1952; Moore, 1951; Pappenfort and Schnall, 1951; Seligmann, 1952, 1953; Woods et al., 1951). In an attempt to resolve these differences, Huppert et al.