Oropharyngeal candidiasis in patients with AIDS or malignancies institutional experience with fluconazole in Colombia

Abstract

A prospective, open, non-comparative study, to assess the efficacy and safety of fluconazole for the treatment of orpharyngeal candidiasis was undertaken in outpatients from several Institutions in Medellin. The number of cases was 52, with microbiologically confirmed candidiasis. That were divided in 2 groups: l. formed by 42 cases, suffering A1DS and 11, formed by 10 patients, with varied Immunodeficiency causes.
Fluconazole was administered in syrup or capsules at the daily dose of 50-100 mg for 5-14 days. No other topical or systemic antifungal treatment was allowed. The cure or Improvement of the fungal infection was evaluated by cultures and by the follow up of the clinical picture. The majority of the patients, in both groups, improved within the first two days treatment. Clinically group I showed 95% cure rote and 5% Improvement, while all cases from group 11 were clinically cured. The mycological assessment revealed the following results in percentages:

CURED    IMPROVED    FAILURE
Group l         85           10              5
Group l l       80           10             10

CURED IA follows up evaluation, one month after the last dose of treatment, revealed that 50% (18 out of 36 patients) remained clinically cured and 50% were reinfected, in group I. For group ll, 8 out of 9 cases that returned remained cured and one case was reinfected.
Regarding safety, only two patients presented adverse effects that could be attributed to the drug under study. One showed mild nausea and the other one presented with dizziness. These symptoms disappeared spontaneously.
We can conclude that fluconazole is an efficient treatment for oropharyngeal candidiasis at the dose of 50-100 mg daily for 5 to 14 days. This treatment presented good compliance and was well tolerated.