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