Chronic mucocutaneous candidiasis. Successful treatment with intermittent oral doses of clotrimazole

Abstract

Treatment of chronic mucocutaneous candidiasis has included drugs, immunotherapy, and replacement of nutritional and endocrine deficiency. Although amphotericin B is the best known and most commonly used form of treatment, the imidazole antibiotic clotrimazole has shown promise as an effective agent that can be given orally with low toxicity. A 9-year-old girl responded to intermittent clotrimazole therapy with complete and prolonged remission. This form of treatment offers advantages in safety and effectiveness over other therapies for chronic mucocutaneous candidiasis.

The treatment of patients with chronic mucocutaneous candidosis and Candida onychomycosis with ketoconazole

“…In chronic mucocutaneous candidosis there are a number uf underlying host abnormalities ranging from genetic to endocrine or immunological disorders (Valdimarsson et al, 1973) and these undoubtedly infiuence the outcome of treatment. Many different approaches to therapy have been used in the past and the most successful of these have been low dose amphotericin B , intermittent oral clotrimazole (Rockoff, 1979), intravenous miconazole (Hay, Clayton & Wells, 1977) and transfer factor (Kirkpatrick, Rich & Bennett, 1971). However, even where there is a satisfactory clinical response it is often only partial and relapse is common.…”

Management of chronic mucocutaneous candidosis

“…However its use is limited by side-effects such as mental or psychotic disturbances and by the induction of liver enzymes which enhance its metabolism. If the drug is given in intermittent courses the latter problem is largely eliminated (Rockoff, 1979) and control of the disease has been obtained.…”