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Evolution of vaginal Candida species recovered from human immunodeficiency virus-infected women receiving fluconazole prophylaxis: the emergence of Candida glabrata? Terry Beirn Community Programs for Clinical Research in AIDS (CPCRA).
Vazquez JA; Sobel JD; Peng G; Steele-Moore L; Schuman P; Holloway W;
December 30, 1999
Clin Infect Dis. 1999 May;28(5):1025-31. Unique Identifier : AIDSLINE

The effect of fluconazole prophylaxis on the vaginal flora of 323 human immunodeficiency virus-infected women was evaluated in a multicenter, randomized, double-blind, placebo-controlled trial. Women with CD4 cell counts of < or = 300/mm3 received either 200 mg of fluconazole per week or placebo. Vaginal surveillance cultures were performed every 3 months. After a follow-up of 29 months, Candida albicans was recovered from 53% of patients receiving fluconazole and 68% of patients assigned placebo. Fluconazole was associated with a 50% reduction in the odds of being colonized with C. albicans but with higher rates for non-albicans Candida species. Candida glabrata was recovered from 40 women assigned fluconazole and 29 assigned placebo (relative odds, 1.96; 95% confidence interval, 0.98-3.94). Fluconazole had an early and persistent effect on the vaginal mycoflora, with the emergence of C. glabrata vaginal colonization within the first 6 months. The effect of fluconazole prophylaxis can be attributed to the reduction in vaginal C. albicans colonization; however, C. glabrata colonization rapidly supervened.

CLINICAL TRIAL JOURNAL ARTICLE MULTICENTER STUDY RANDOMIZED CONTROLLED TRIAL *Antibiotic Prophylaxis Antibiotics, Antifungal/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/*MICROBIOLOGY/PREVENTION & CONTROL Candida/CLASSIFICATION/*ISOLATION & PURIF Candida albicans/DRUG EFFECTS/ISOLATION & PURIF Candidiasis, Vulvovaginal/*MICROBIOLOGY/PREVENTION & CONTROL CD4 Lymphocyte Count Double-Blind Method Female Fluconazole/*THERAPEUTIC USE Human Risk Factors

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