Comparison of Fluconazole and Ketoconazole for Oropharyngeal Candidiasis in Aids

Wit, Stéphane De; Goossens, H.; Weerts, Danièle; Clumeck, Nathan

doi:10.1016/s0140-6736(89)92572-5

Cited by 181 publications

(58 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Response rates ranged from Amphotericin B transplantation 100% (6) to 78% (14) or 71% (15). Relapse rates ranged from 46% (6) to 27% (14).…”

Section: * Corresponding Authormentioning

confidence: 99%

“…Clearance is predominantly renal, with most of the administered dose excreted unchanged in urine (2,12). Studies with adult patients have shown that the drug is less toxic than amphotericin B (10) and more effective than ketoconazole (6). In particular, fluconazole seems not to be associated with the endocrine effect that has been reported for other azole compounds (11).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Fluconazole in the treatment of candidiasis in immunocompromised children

Viscoli

Castagnola

Fioredda

et al. 1991

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Fluconazole, a new triazole derivative, was evaluated in a pilot study of 34 episodes of candidiasis in 24 children. All the patients had predisposing conditions, such as human immunodeficiency virus infection, cancer, organ or bone marrow transplantation, neonatal age and malnutrition, and obstructive uropathy. The drug was administered at 6 mg/kg (body weight) once daily either orally or intravenously. Two patients with fungemia due to Candida parapsilosis required an increased dosage of 12 mg/kg. Clinical and microbiological success was achieved in 30 of 34 cases (88%). Drug-related transaminase increases were observed in two cases (6%). Fluconazole may represent an effective alternative to amphotericin B in the treatment of candidiasis in children. Comparative trials are necessary to assess optimal dosages and efficacy.

show abstract

“…Response rates ranged from Amphotericin B transplantation 100% (6) to 78% (14) or 71% (15). Relapse rates ranged from 46% (6) to 27% (14).…”

Section: * Corresponding Authormentioning

confidence: 99%

mentioning

confidence: 99%

Fluconazole in the treatment of candidiasis in immunocompromised children

Viscoli

Castagnola

Fioredda

et al. 1991

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Although this infection is not life-threatening, the sustained immunosuppression seen in these patients facilitates recurrences of infection (9). Consequently, several courses of acuteor long-term suppressive therapy are often required and may contribute to the development of resistant strains (3,4,21).…”

mentioning

confidence: 99%

In vitro activity of itraconazole against fluconazole-susceptible and -resistant Candida albicans isolates from oral cavities of patients infected with human immunodeficiency virus

Barchiesi

Colombo

McGough

et al. 1994

Antimicrob Agents Chemother

View full text Add to dashboard Cite

A broth macrodilution technique, which was performed by following the recommendations provided by the National Committee for Clinical Laboratory Standards (document M27-P), was applied to study the in vitro activity of itraconazole against fluconazole-susceptible and -resistant Candida albicans isolates from the oral cavities of 100 patients infected with human immunodeficiency virus. The in vitro data demonstrated that itraconazole had good activity against the tested isolates; for 90%o of all strains of C. albicans, MICs were 1 ,Lg/ml, and only one isolate was highly resistant to this triazole (MIC, >16 ,ug/ml). However, the itraconazole MICs for the fluconazole-susceptible isolates were significantly lower than those for the fluconazole-resistant isolates; the MICs for 50 and 90%o of the isolates tested were .0.03 and 0.25 ,ug/ml, respectively, for the fluconazole-susceptible isolates and 0.5 and 1 ,ug/ml, respectively, for the fluconazole-resistant isolates (P = 0.00001). Our findings could be of clinical relevance because human immunodeficiency virus-infected patients who fail fluconazole therapy for oral and/or esophageal candidiasis may require itraconazole at doses higher than those used in standard therapy.Oropharyngeal candidiasis caused by Candida albicans is the most commonly diagnosed opportunistic infection in human immunodeficiency virus (HIV)-infected patients (17). Although this infection is not life-threatening, the sustained immunosuppression seen in these patients facilitates recurrences of infection (9). Consequently, several courses of acuteor long-term suppressive therapy are often required and may contribute to the development of resistant strains (3, 4, 21).Fluconazole and itraconazole are both used either in the treatment of acute oropharyngeal candidiasis or in the prophylaxis of oropharyngeal candidiasis in these patients (1). The lack of standardized methods for in vitro antifungal susceptibility testing presents difficulties in recognizing resistant strains. The Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards (NCCLS) has recently proposed a broth macrodilution reference method for susceptibility testing of yeasts (10). In the study described here, we investigated the in vitro activity of itraconazole against fluconazole-susceptible and -resistant C. albicans isolates from the oral cavities of 100 HIV-infected patients by using the proposed NCCLS method. patients, and each strain represented a unique isolate from a patient. The isolates were chosen from among all C. albicans isolates sent to the laboratory for in vitro susceptibility testing with fluconazole by a previously published broth macrodilution method (15). In order to obtain isolates of C. albicans with different patterns of in vitro susceptibility to fluconazole, we included isolates for which fluconazole MICs ranged from <1.25 to >80 ,ug/ml. All of the isolates were retested for their susceptibilities to fluconazole and tested for their susceptibilities to itra...

show abstract

“…At most centres,¯uconazole has become the drug of choice for oesophageal candidiasis in AIDS. Randomized trials have shown¯uconazole to be superior to ketoconazole for both oropharyngeal 19,20 and oesophageal candidiasis. 21 In a prospective randomized trial, Laine and colleagues 21 compared ketoconazole 200 mg/day to¯uconazole 100 mg/day in 143 patients with AIDS and oesophageal candidiasis.…”

Section: 10±12mentioning

confidence: 99%

The therapy of gastrointestinal infections associated with the acquired immunodeficiency syndrome

Wilcox

Mönkemüller

1997

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Although there have been dramatic strides in the therapy of human immunodeficiency virus infection over the last few years, the number of infected people world‐wide is tremendous and, at least in developing countries, continues to expand. Complications which involve the gastrointestinal tract are common in these patients, because the gut is a major site for involvement by opportunistic infections and neoplasms in patients with the acquired immunodeficiency syndrome. It is important to recognize the clinical spectrum of gastrointestinal diseases, as well as the appropriate and most cost‐effective diagnostic strategies, as therapies for a number of these disorders are both widely available and highly effective. This review summarizes the major gastrointestinal infections which are seen in patients with the acquired immunodeficiency syndrome, and their treatment.

show abstract

Comparison of Fluconazole and Ketoconazole for Oropharyngeal Candidiasis in Aids

Cited by 181 publications

References 18 publications

Fluconazole in the treatment of candidiasis in immunocompromised children

Fluconazole in the treatment of candidiasis in immunocompromised children

In vitro activity of itraconazole against fluconazole-susceptible and -resistant Candida albicans isolates from oral cavities of patients infected with human immunodeficiency virus

The therapy of gastrointestinal infections associated with the acquired immunodeficiency syndrome

Contact Info

Product

Resources

About