Document 0094
 DOCN  M94A0094
 TI    Correlation between antifungal susceptibility testing of Candida
       isolates from patients with HIV infection and clinical results after
       treatment with fluconazole.
 DT    9412
 AU    Ruhnke M; Eigler A; Engelmann E; Geiseler B; Trautmann M; Abteilung fur
       Hamatologie/Onkologie, Medizinischen Klinik,; Universitatsklinikum
       Rudolf Virchow/Charlottenburg, Freie; Universitat Berlin, Germany.
 SO    Infection. 1994 Mar-Apr;22(2):132-6. Unique Identifier : AIDSLINE
       MED/94350502
 AB    In an open-label controlled study 23 HIV-infected patients (CDC IV A-E)
       with documented oropharyngeal candidosis were treated with 100 mg
       fluconazole orally over 5 days (53 episodes; 1-6 treatments/patient).
       Efficacy data were compared with a control group of 21 patients who
       received treatment for 10-21 days with 100 mg fluconazole for
       candidosis. Candida isolates were repeatedly recovered from patients
       before and after treatment with fluconazole and antifungal
       susceptibility testing (microbroth-dilution) was done. Inoculum size,
       medium pH, incubation time and temperature were standardized. Up to 85%
       of patients responded to therapy clinically and mycologically. Candida
       albicans was the most important yeast (86%) isolated from cultures of
       oral washings. In 90% of C. albicans isolates MIC to fluconazole were
       low (< or = 1.56 mg/l). Primary resistance to fluconazole was not seen,
       but secondary resistance occurred in two cases clinically and in vitro
       (MIC > or = 25 mg/l). Short treatment for 5 days was as successful as
       for 10 to 21 days without leading to significantly more recurrences of
       oral candidosis in these patients. Selection of Candida spp. other than
       C. albicans (e.g. Candida krusei, Torulopsis glabrata) under repeated
       fluconazole treatment occurred rarely. One patient developed clinical
       signs of chronic recurrent candidiasis, where only C. krusei could be
       cultured repeatedly.
 DE    Administration, Oral  AIDS-Related Opportunistic Infections/*DRUG
       THERAPY/MICROBIOLOGY  Candida/*DRUG EFFECTS/GROWTH &
       DEVELOPMENT/ISOLATION & PURIF  Candidiasis, Oral/*DRUG
       THERAPY/MICROBIOLOGY  Drug Resistance, Microbial  Female
       Fluconazole/*THERAPEUTIC USE  Human  Male  Microbial Sensitivity Tests
       Recurrence  Time Factors  Treatment Outcome  CLINICAL TRIAL  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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