FLUCONAZOLE RESISTANCE IN OROPHARYNGEAL CANDIDIASIS

Project: Research project

Project Details

Description

Fluconazole is very effective in the treatment of oral thrush, but an
increasing number of patients with recurrent oropharyngeal candidiasis
have developed fluconazole-resistant yeasts following repeated courses of
fluconazole therapy. Fluconazole resistance can develop in a single
persistent strain of yeast, but more commonly fluconazole resistance
results from emergence of a different Candida albicans strain or another
Candida species. Higher doses of fluconazole are more effective against
resistant strains in murine candidiasis, but the utility of identifying
resistant isolates and treating resistant yeasts with high doses of
fluconazole is not established. Thus, the objectives of this proposal are
to define prospectively the epidemiology of fluconazole-resistant
oropharyngeal candidiasis, to correlate therapeutic response with
fluconazole resistance, and to evaluate the role of higher doses of
fluconazole in treating resistant yeasts. These objectives will be
achieved by longitudinally evaluating patients with HIV infection/AIDS
treated with fluconazole for recurrent oropharyngeal candidiasis. The
goal of these studies is to improve the treatment of oropharyngeal
candidiasis in patients with HIV infection/AIDS. The specific aims of
this proposal are: 1) To longitudinally evaluate a cohort of patients with
recurrent oropharyngeal candidiasis for the development of fluconazole
resistance and to correlate that resistance with clinical response to
therapy; 2) To establish strain identity using molecular characterization
of the yeasts in order to establish the epidemiology of fluconazole-
resistant oropharyngeal candidiasis; 3) To correlate antifungal
susceptibility testing with clinical outcome and to determine the utility
of screening susceptibility techniques to detect fluconazole resistant
yeasts; 4) To evaluate high doses of fluconazole against resistant yeasts
in a murine model of candidiasis; 5) To determine the clinical utility of
high doses of fluconazole in treating patients with fluconazole-resistant
yeasts.
StatusFinished
Effective start/end date9/30/942/28/05

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $100,000.00
  • National Institutes of Health: $250,000.00
  • National Institutes of Health: $258,265.00
  • National Institutes of Health: $62,569.00
  • National Institutes of Health
  • National Institutes of Health: $251,848.00
  • National Institutes of Health: $252,330.00

ASJC

  • Medicine(all)
  • Dentistry(all)

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