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Fluconazole dosage options in treatment & prophylaxis of oral and esophageal candidiasis in HIV/AIDS.


Int Conf AIDS. 1993 Jun 6-11;9(1):368 (abstract no. PO-B09-1398). Unique

Fungal infections are exceedingly common in patients with HIV and AIDS. Even with prophylactic therapy, recurrence rates are high. We have conducted a literature review of the treatment (tx) and prophylaxis (pro) options of fluconazole (flu) that show clear dosing recommendations. Most trials show significantly better cure rates with flu when compared to ketoconazole or clotrimazole including oral candidiasis that is refractory to nystatin, clotrimazole and ketoconazole. Dosing in studies varies from 50 mg to 200 mg daily for tx however, manufacturer recommended doses of 50 mg daily has been shown to be as effective as 100 mg daily in achieving clinical and mycological cure. The manufacturer has no dosing recommendations regarding pro. Several studies have linked dosing with stage of HIV disease showing that earlier disease requires lower doses of flu than more advanced disease. Doses of 50 mg every other day in early to mid-stage HIV infection without a history of candida infection were adequate pro doses but patients with clinical AIDS who had previous episodes of oral candidiasis require doses of 50 mg daily to reduce the recurrence rate. Drug costs should not solely determine choice of anti-fungal agent however, with increasingly scarce resources, using the lowest effective dose of flu will reduce costs, reduce the incidence of toxicity and may reduce emergence of resistant strains.

*AIDS-Related Opportunistic Infections/DRUG THERAPY *AIDS-Related Opportunistic Infections/PREVENTION & CONTROL *Candidiasis/DRUG THERAPY *Candidiasis/PREVENTION & CONTROL *Candidiasis, Oral/DRUG THERAPY *Fluconazole/THERAPEUTIC USE


Information in this article was accurate in November 30, 1993. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.