We agree with Girmenia and colleagues regarding the role of fluconazole prophylaxis in the increasing frequency of C krusei infections. In our article,1 we pointed out that several multi-institutional studies of fluconazole vs placebo prophylaxis failed to demonstrate any increase in colonization or infection with C krusei among patients who had received fluconazole. We cited 2 studies of C krusei infection in which fluconazole use did not play a role2,3 and stated: "It may be that there are nosocomial sources of C krusei within some hospitals and that colonization and infection are facilitated by the selective effect of fluconazole usage."1 However, we did not suggest that fluconazole therapy was associated with C krusei infection.
Bodey GP, Hanna HA, Raad II. Fluconazole and Candida krusei Fungemia—Reply. Arch Intern Med. 2001;161(18):2267-2269. doi: