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Correlation between in vitro resistance to fluconazole and clinical outcome of oropharyngeal candidiasis in HIV-infected patients

  • C. Quereda
  • A. M. Polanco
  • C. Giner
  • A. Sánchez-Sousa
  • E. Pereira
  • E. Navas
  • J. Fortún
  • A. Guerrero
  • F. Baquero
Article

Abstract

Fifty episodes of oropharyngeal candidiasis in HIV-infected patients were analyzed prospectively in order to evaluate the clinical response to fluconazole. The minimum inhibitory concentrations (MICs) of fluconazole for theCandida strains isolated from the pharynx were correlated with the clinical response. Treatment with fluconazole (100 mg/day) was successful in 86% of the cases. A good clinical outcome followed in 97% of the cases when a strain sensitive to fluconazole was isolated. This figure fell to 22% when the strain was resistant to fluconazole (p<0.001). The rate of post-treatment colonization was high (87%), and selection of non-albicans Candida species occurred in 23% of the cases. In conclusion, fluconazole treatment for oropharyngeal candidiasis of HIV-infected patients was useful in most cases, but less sensitive non-albicans species can be selected. Most treatment failures were associated with increased MICs of fluconazole for the strains isolated before treatment; therefore, susceptibility testing is recommended as an aid in clinical decision-making for the use of the azole group of drugs.

Keywords

Internal Medicine Clinical Outcome Minimum Inhibitory Concentration Clinical Response Inhibitory Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • C. Quereda
    • 1
  • A. M. Polanco
    • 1
  • C. Giner
    • 1
  • A. Sánchez-Sousa
    • 1
  • E. Pereira
    • 1
  • E. Navas
    • 1
  • J. Fortún
    • 1
  • A. Guerrero
    • 1
  • F. Baquero
    • 1
  1. 1.Infectious Diseases Unit, Department of Microbiology, Ramón y Cajal HospitalNational Institute of Health (INSA-LUD)MadridSpain

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