Maenza JR, Merz W, Romagnoli M, Moore R, Keruly J, Gallant J; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 95 (abstract no. We.B.3223).
Johns Hopkins University School Of Medicine, Baltimore, MD, USA. Fax (410) 955-7889.
Objectives: To determine if treatment of oral thrush is associated with decreased fluconazole susceptibility of fungal isolates during and immediately after a course of antifungal therapy. Methods: To date, oral fungal cultures have been obtained from 30 HIV-infected patients who presented with thrush. Cultures were repeated during and/or following treatment at 2 and 4 weeks after the baseline culture. Results: Fifteen patients were receiving antifungal therapy at presentation. Treatment begun or continued at the baseline visit included: nystatin (n=1), clotrimazole (n=10), ketoconazole (n=1), fluconazole (n=15), itraconazole (n=1), and amphotericin B (n=2). Baseline cultures showed that Candida albicans isolated from patients already receiving fluconazole (n=7) had higher MICs (median 64 mcg/mL) than those on topical agents (n=5, median .5 mcg/mL, p=.01) or no therapy (n=15, median .5 mcg/mL, p=.002). In patients not receiving fluconazole at baseline, treatment with fluconazole during the study period resulted in sterile cultures, or was not associated with an increase in fluconazole MIC in cultures that remained positive for C. albicans. The one patient treated with ketoconazole had persistent thrush while on therapy: C. albicans isolates showed increasing MICs during follow-up from .5 mcg/mL at baseline to 4 mcg/mL at 2 weeks to 64 mcg/mL at 4 weeks. Conclusions: We found no evidence of decreasing fluconazole susceptibility in C. albicans during short-term treatment of oral thrush with this agent.
Publication Types:
Keywords:
- Amphotericin B
- Candida albicans
- Candidiasis
- Candidiasis, Oral
- Clotrimazole
- Disease Susceptibility
- Fluconazole
- Fungi
- HIV Infections
- Humans
- Itraconazole
- Ketoconazole
- Microbial Sensitivity Tests
- Nystatin
- therapy
Other ID:
UI: 102219475
From Meeting Abstracts