Fluconazole in the treatment of oropharyngeal candidosis in HIV‐positive patients

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Abstract
106 HIV-positive patients with 129 episodes of oropharyngeal Candida Infection were treated with fluconazole (50–300 mg/d). Treatment lasted from 4 to 23 days. The majority of patients were in more advanced stages of HIV infection (82 % AIDS cases). Therapy with fluconazole led to complete healing or improvement of clinical symptoms in 93 % of all treatment courses. However, according to cultural findings, an elimination or recession of pathogens was achieved in only 70 % of cases. Cultural monitoring showed a slow reduction of pathogens, as opposed to a fairly rapid clinical improvement. Candida albicans was the most frequently isolated Candida species (n = 128); the most selected Candida species during treatment were C. glabrata, C. krusei, and C. inconspicua. It is remarkable that C. glabrata, a low-grade pathogen, caused enanthema in 2 patients and a typical oral thrush in 1 patient. Fluconazole was well-tolerated, and apart from mild gastro-intestinal symptoms in 1 patient, no severe side effects were observed.