Fluconazole‐resistant oral candidosis in a repeatedly treated female AIDS patient

Thoma-Greber, Eva; Körting, Hans Christian; Bogner, Johannes R.; Goebel, Frank-Detlef

doi:10.1111/j.1439-0507.1994.tb00282.x

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…5 With these benefits, however, there is also a potential for the induction of azole resistance. [5][6][7] The mechanism of azole resistance against the Candida spp. is multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Azole-Resistant Oropharyngeal Candidiasis with Topical Amphotericin B

et al. 2002

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“…5 With these benefits, however, there is also a potential for the induction of azole resistance. [5][6][7] The mechanism of azole resistance against the Candida spp. is multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Azole-Resistant Oropharyngeal Candidiasis with Topical Amphotericin B

et al. 2002

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“…Recently, resistance has been reported increasingly with azole agents 2 . A low incidence of resistance has been reported so far for itraconazole, suggesting that it may be less commonly encountered than with ketoconazole and fluconazole 2–12 . The exact incidence and conditions for the development of resistance to each azole agent remain to be ascertained, as does the potential for cross‐resistance to other azoles.…”

Section: Discussionmentioning

confidence: 99%

Clotrimazole troche vs. itraconazole oral solution in the treatment of oral candidosis in AIDS patients

2000

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This prospective study was designed to compare the efficacy and safety of itraconazole oral solution with those of clotrimazole troche in the treatment of oropharyngeal candidosis in acquired immunodeficiency syndrome (AIDS) patients. Patients were excluded if they had been treated with any antifungal agents 2 weeks prior to the study entry, were pregnant or nursing, or had significant liver disease. Twenty-nine patients (20 men and nine women), with a mean age of 32 years (15-62 years), were randomly, observer-blind treated with clotrimazole troche (10 mg, five times daily) or itraconazole oral solution (100 mg/10 mL, twice daily) for 1 week. Clinical and mycologic assessment were carried out on four consecutive days, in week 1, week 2, and week 4 after the start of treatment. Clinical evaluation was assessed by a scoring method (0-3, absent to severe) as follows: soreness, change in taste, erythema, removable white plaque, and extent of lesions. Mycologic assessment was performed by KOH preparation and fungal culture. Global evaluation, which is a summary of clinical and mycologic assessment at the end of treatment, was classified as cure (all signs and symptoms resolved with no evidence of infection), improvement (decrease in clinical score without complete resolution), or failure (lack of improvement or further deterioration). (Pons V, Greenspan D, Debruin M. Therapy for oropharyngeal candidiasis in HIV-infected patients: a randomized, prospective multicenter study of oral fluconazole versus clotrimazole troches. J Acquir Immune Defic Syndr 1993; 6: 1311-1316. ) Global evaluation at week 2 and week 4 was made in terms of no relapse or relapse. Any intercurrent medical events, whether human immunodeficiency virus (HIV)-related or not, were recorded. An intention-to-treat analysis was employed. Data were analyzed using the chi-squared test, Mann-Whitney U-test, and Student's t-test.

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“…Consequently, with extensive use resistance to these agents has been reported, particularly fluconazole. [38][39][40][41] Azole resistance in Candida has been the most widely observed and studied for fluconazole Resistance to the azoles is attributed to quantitative or qualitative modifications of target enzymes, reduced access of the drug to the target enzyme or by a combination of these mechanisms.…”

Section: Resistance Of Azolesmentioning

confidence: 99%

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2013

IJPSR

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Fungal infections in critically ill or immunosuppressed patients were increasing in incidence in the human population over the last 1-2 decades. There were few advances in antifungal therapy and, until recently, there were few choices from which to select a treatment for systemic mycoses. However, in the past decade, there have been several developments in this area. Antifungal agents are sufficiently diverse in activity, toxicity, and drug interaction potential. Azoles are synthetic and semi-synthetic compounds. They have a broad spectrum of activity. Triazole antifungals are active to treat an array of fungal pathogens, whereas imidazoles are used almost exclusively in the treatment of superficial mycoses and vaginal candidiasis. Despite the advances, serious fungal infections remain difficult to treat, and resistance to the available drugs is emerging. Use of the currently available azoles in combination with other antifungal agents with different mechanisms of action is likely to provide enhanced efficacy. The present review aims to explore the pharmacology, pharmacokinetics, spectrum of activity, safety, toxicity and potential for drug-drug interactions of the azole antifungal agents. INTRODUCTION: Fungi are common pathogens in critically ill or immunosuppressed patients. Fungal infections (mycoses), though not as frequent as bacterial or viral infections, have nonetheless been increasing in incidence in the human population over the last 1-2 decades. In addition, a number of fungal infections can be difficult to treat, even when the offending organism is identified and appropriate therapy is applied. Fungi have unique characteristics, distinct from their mammalian hosts, allowing for selective targeting of therapeutic drugs.

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Fluconazole‐resistant oral candidosis in a repeatedly treated female AIDS patient

Cited by 7 publications

References 15 publications

Treatment of Azole-Resistant Oropharyngeal Candidiasis with Topical Amphotericin B

Treatment of Azole-Resistant Oropharyngeal Candidiasis with Topical Amphotericin B

Clotrimazole troche vs. itraconazole oral solution in the treatment of oral candidosis in AIDS patients

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