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M94A0094.TXT
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1994-10-01
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Document 0094
DOCN M94A0094
TI Correlation between antifungal susceptibility testing of Candida
isolates from patients with HIV infection and clinical results after
treatment with fluconazole.
DT 9412
AU Ruhnke M; Eigler A; Engelmann E; Geiseler B; Trautmann M; Abteilung fur
Hamatologie/Onkologie, Medizinischen Klinik,; Universitatsklinikum
Rudolf Virchow/Charlottenburg, Freie; Universitat Berlin, Germany.
SO Infection. 1994 Mar-Apr;22(2):132-6. Unique Identifier : AIDSLINE
MED/94350502
AB In an open-label controlled study 23 HIV-infected patients (CDC IV A-E)
with documented oropharyngeal candidosis were treated with 100 mg
fluconazole orally over 5 days (53 episodes; 1-6 treatments/patient).
Efficacy data were compared with a control group of 21 patients who
received treatment for 10-21 days with 100 mg fluconazole for
candidosis. Candida isolates were repeatedly recovered from patients
before and after treatment with fluconazole and antifungal
susceptibility testing (microbroth-dilution) was done. Inoculum size,
medium pH, incubation time and temperature were standardized. Up to 85%
of patients responded to therapy clinically and mycologically. Candida
albicans was the most important yeast (86%) isolated from cultures of
oral washings. In 90% of C. albicans isolates MIC to fluconazole were
low (< or = 1.56 mg/l). Primary resistance to fluconazole was not seen,
but secondary resistance occurred in two cases clinically and in vitro
(MIC > or = 25 mg/l). Short treatment for 5 days was as successful as
for 10 to 21 days without leading to significantly more recurrences of
oral candidosis in these patients. Selection of Candida spp. other than
C. albicans (e.g. Candida krusei, Torulopsis glabrata) under repeated
fluconazole treatment occurred rarely. One patient developed clinical
signs of chronic recurrent candidiasis, where only C. krusei could be
cultured repeatedly.
DE Administration, Oral AIDS-Related Opportunistic Infections/*DRUG
THERAPY/MICROBIOLOGY Candida/*DRUG EFFECTS/GROWTH &
DEVELOPMENT/ISOLATION & PURIF Candidiasis, Oral/*DRUG
THERAPY/MICROBIOLOGY Drug Resistance, Microbial Female
Fluconazole/*THERAPEUTIC USE Human Male Microbial Sensitivity Tests
Recurrence Time Factors Treatment Outcome CLINICAL TRIAL JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).