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The effect of daily (D) versus weekly (W) fluconazole (FZ) prophylaxis on susceptibility of oral candida isolates in HIV-infected patients.




 

3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:158. Unique

Objective: (1) To determine if D or W fluconazole alters the species or Fz susceptibility of yeast isolates colonizing the oropharynx of HIV (+) patients. (2) To determine if pre-study antifungal therapy alters fungal colonization. Methods: A subset of HIV(+) patients with CD4 less than 100 enrolled in a randomized, blinded trial of 200 mg D versus 400 mg W FZ had surveillance oropharyngeal fungal cultures at baseline and 6 months. For positive cultures, species identification and FZ MIC using the NCCLS standard assay (read at 48 hours) were determined. Results: Baseline C.albicans isolates from 12 patients with pre-study FZ use had a geometric mean (GM) MIC of .94. The number of cultures, percent positive, and GM MIC for baseline and 6-month isolates Were:(Table: See Text). Of 16 baseline/6 month pairs, 4 (2D,2W) C.albicans isolates were replaced with non-albicans. In the remaining 11 pairs (3D,8W), the GM MIC for baseline C.albicans was unchanged at 6 months. Conclusion: Treatment with either daily or weekly fluconazole reduced oropharyngeal candida colonization but the reduction was not significant in the weekly group. Although the FZ sensitivity of C.albicans strains appeared not to change, the proportion of non-albicans isolates at 6 months was higher.

Antifungal Agents/ADMINISTRATION & DOSAGE/PHARMACOLOGY/ *THERAPEUTIC USE CD4 Lymphocyte Count Candida albicans/*DRUG EFFECTS/ISOLATION & PURIF Candidiasis/COMPLICATIONS/*PREVENTION & CONTROL Fluconazole/ADMINISTRATION & DOSAGE/PHARMACOLOGY/*THERAPEUTIC USE HIV Infections/*COMPLICATIONS Human Microbial Sensitivity Tests Oropharynx/MICROBIOLOGY ABSTRACT



 




Information in this article was accurate in November 30, 1996. 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.