Abstract
In an open multicentre study the efficacy and safety of fluconazole versus ketoconazole were evaluated in the treatment of 46 pediatric patients with oropharyngeal candidiasis and AIDS or HIV infection. Twenty-four subjects received oral fluconazole in a dosage of 3 mg/kg/day and 22 subjects received oral ketoconazole in a dosage of 7 mg/kg/day. The treatment duration ranged from 5 to 49 days. Results showed that fluconazole and ketoconazole have comparable efficacy and safety in the treatment of oropharyngeal candidiasis in HIV-infected children. Patients treated with fluconazole had higher clinical and mycological cure rates at the end of therapy (88 % and 71 % respectively) than those treated with ketoconazole (81 % and 57 % respectively). One case of drug-related side effects (diarrhea and abdominal pain) in a patient receiving ketoconazole resulted in discontinuation of treatment. Follow-up examinations 2 and 4 weeks post-treatment showed a comparably high rate of relapse in both patient groups.
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Fleming PL, Gwing M, Oxtoby MJ Epidemiology of HIV infection. In: Yoge R, Connor E (ed): Management of HIV infections in infants and children. CV Mosby, St Louis, 1992, p. 7–22.
Oxtoby MJ Perinatally acquired infection. In: Pizzo P, Wilfert CM (ed): Pediatric AIDS, the challenge of HIV infection in infants, children and adolescents. Williams & Wilkins, Baltimore, 1991, p. 3–20.
Taviatian A, Raufman JP, Rosenthal LE, Weber J, Webber CA, Dincsoy HP Ketoconazole-resistantCandida esophagitis in patients with acquired immunodeficiency syndrome. Gastroenterology 1986, 90: 443–445.
Lewis JH, Zimmerman HJ, Benson GD, Ishak KG Hepatic injury associated with ketoconazole therapy. Gastroenterology 1984, 86: 503–513.
Lazar JD, Hilligoss DM The clinical pharmacology of fluconazole. Seminars in Oncology 1990, 17, Supplement 6: 14–18.
Centers for Disease Control Classification for human immunodeficiency virus infection in children under 13 years of age. Morbidity and Mortality Weekly Report 1987, 36: 225–230, 235–236.
Hay RJ Overview of studies of fluconazole in oropharyngeal candidiasis. Reviews of Infectious Diseases 1990, 12, Supplement 3: 334–337.
Dupont B, Drouhet E Fluconazole in the management of oropharyngeal candidiasis in a predominantly HIV-antibody-positive group of patients. Journal of Medical and Veterinary Mycology 1988, 26: 67–71.
Koletar SL, Russel JA, Fass RJ, Plouffe JF Comparison of oral fluconazole and clotrimazole troches as treatment for oral candidiasis in patients infected with human immunodeficiency virus. Antimicrobial Agents and Chemotherapy 1990, 34-11: 2267–2268.
De Wit S, Weerts D, Goossens H, Clumeck N Comparison of fluconazole and ketoconazole for treatment of oropharyngeal candidiasis in AIDS and ARC patients. Lancet 1989, i: 746–747.
Bunnin N Oral fluconazole for treatment of disseminated fungal infections. Pediatric Infectious Disease Journal 1989, 8: 62.
Shojiro A, Kosei I Experience of fluconazole in pediatric patients. Japanese Journal of Antibiotics 1989, 170: 170.
Viscoli C, Castagnola E, Fioredda F, Ciravegna B, Barigione G, Terragna A Fluconazole in the treatment of candidiasis in immunocompromised children. Antimicrobial Agents and Chemotherapy 1991, 35: 365–367.
Gil A, Lavilla P, López Dupla M, Valencia E, Pintado V, Khamashta M, Garcia Puing J, Ortiz Vasquez J Tratamiento de la candidiasis esofagica con fluconazol en el síndrome de la inmunodeficiencia adquirida. Estudio comparativo de dos pautas terapeúticas. Medicina Clinica 1992, 98: 612–617.
Lavilla P, Gil A, Valencia E, Pintado V, Lopez Dupla M, Kamashta M, Garcia Puig J, Ortiz Vasquez J Profilaxis secundaria de la candidiasis esofagica con fluconazol en el síndrome de immunodeficiencia adquirida. Revista Clinica Espanola 1992, 190: 115–119.
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A. Roberts, J. Tricoire, Hôpital Purpan, Toulouse, France; D.M. Gibb, H. Holzel, V.M. Novelli, The Hospitals for Sick Children, London, UK; M.I. de Jose, Hospital Infantil La Paz, Madrid, Spain; B. Perez-Gorricho, Hospital Niño Jesus, Madrid, Spain; C. Fortuny-Guasch, Hospital Clinico y Provincial, Barcelona, Spain; A. Mur-Sierra, Hospital Nuestra Señora del Mar, Barcelona, Spain.
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Hernández-Sampelayo, T., a Multicentre Study Group. Fluconazole versus ketoconazole in the treatment of oropharyngeal candidiasis in HIV-infected children. Eur. J. Clin. Microbiol. Infect. Dis. 13, 340–344 (1994). https://doi.org/10.1007/BF01974616
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DOI: https://doi.org/10.1007/BF01974616