TY - JOUR
T1 - Clinical evaluation and microbiology of oropharyngeal infection due to fluconazole-resistant Candida in human immunodeficiency virus - Infected patients
AU - Revankar, Sanjay G.
AU - Dib, Olga P.
AU - Kirkpatrick, William R.
AU - McAtee, Robert K.
AU - Fothergill, Annette W.
AU - Rinaldi, Michael G.
AU - Redding, Spencer W.
AU - Patterson, Thomas F.
N1 - Funding Information:
Received 1 August 1997; revised 15 December 1997. The study was approved by the institutional review boards at both centers, and informed consent was obtained from each patient. Grant support: This work was supported by the National Institute of Dental Research (1 R01 DE11381-01), the National Institute of Health for the Frederic C. Bartter General Clinical Research Center (M01-RR-01346), and Pfizer. Reprints or correspondence: Dr. Sanjay G. Revankar, University of Texas Health Science Center at San Antonio, Department of Medicine/Infectious Diseases, 7703 Floyd Curl Drive, San Antonio, Texas 78284-7881.
PY - 1998
Y1 - 1998
N2 - Signs and symptoms of oropharyngeal candidiasis (OPC) were correlated with microbiology and clinical response to fluconazole in a cohort of patients with advanced human immunodeficiency virus (HIV) infection and recurrent OPC. Sixty-four HIV-infected patients with a median CD4 cell count of <50/mm3 (range, 3-318/mm3) who presented with OPC were enrolled in a longitudinal study. Specimens for cultures were taken weekly until clinical resolution. Therapy with fluconazole was increased weekly as required to a maximum daily dose of 800 mg until resolution of symptoms and oral lesions. Resistant or dose-dependent susceptible yeasts, defined as a minimum inhibitory concentration of ≤16 μg/mL, were detected in 48 (31%) of 155 episodes. Clinical resolution with fluconazole therapy occurred in 107 (100%) of 107 episodes with susceptible yeasts vs. 44 (92%) of 48 episodes with resistant or dose-dependent susceptible strains (P = .008). Patients from whom fluconazole-resistant yeasts were isolated required longer courses of therapy and higher doses of fluconazole for response, but overall, excellent responses to fluconazole were seen in patients with advanced HIV infection.
AB - Signs and symptoms of oropharyngeal candidiasis (OPC) were correlated with microbiology and clinical response to fluconazole in a cohort of patients with advanced human immunodeficiency virus (HIV) infection and recurrent OPC. Sixty-four HIV-infected patients with a median CD4 cell count of <50/mm3 (range, 3-318/mm3) who presented with OPC were enrolled in a longitudinal study. Specimens for cultures were taken weekly until clinical resolution. Therapy with fluconazole was increased weekly as required to a maximum daily dose of 800 mg until resolution of symptoms and oral lesions. Resistant or dose-dependent susceptible yeasts, defined as a minimum inhibitory concentration of ≤16 μg/mL, were detected in 48 (31%) of 155 episodes. Clinical resolution with fluconazole therapy occurred in 107 (100%) of 107 episodes with susceptible yeasts vs. 44 (92%) of 48 episodes with resistant or dose-dependent susceptible strains (P = .008). Patients from whom fluconazole-resistant yeasts were isolated required longer courses of therapy and higher doses of fluconazole for response, but overall, excellent responses to fluconazole were seen in patients with advanced HIV infection.
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U2 - 10.1086/513950
DO - 10.1086/513950
M3 - Article
C2 - 9564483
AN - SCOPUS:0031916096
VL - 26
SP - 960
EP - 963
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 4
ER -