British HIV Association guidelines on the management of opportunistic infection in people living with HIV: The clinical management of Candidiasis 2019

Abstract

Clinical management of Candida in HIV 15 Microbiol Infect 2012; 18 (Suppl 7): 9-18. 51 Lindau ST, Hoffmann JN, Lundeen K et al. Vaginal selfswab specimen collection in a home-based survey of older women: methods and applications. J Gerontol B Psychol Sci Soc Sci 2009; 64 (Suppl 1): i106-i118.

Role of Antifungal Combinations in Difficult to Treat Candida Infections

“…In general, mucosal candidiasis is treated with a single drug, but in some refractory cases, drug combinations might be more effective. For oropharyngeal candidiasis, monotherapy is recommended, especially with fluconazole, when non-resistant strains are involved [ 1 , 78 ]. In a small trial with twenty patients with Candida esophagitis, the combination of amphotericin B plus flucytosine showed no advantage compared with fluconazole alone [ 87 ].…”

“…However, in complicated vulvovaginitis (such as the case of recurrent vulvovaginitis), biofilm production or cases caused by non-albicans species, other alternatives are recommended. They includes topical 17% flucytosine cream alone or in combination with 3% amphotericin B cream administered daily for 14 days or nystatin vaginal cream combined with flucytosine [ 1 , 78 ]. A topical combination of miconazol plus domiphen bromide was demonstrated to be effective in a vulvovaginitis animal model in rats [ 89 ].…”

British HIV Association guidelines on the management of opportunistic infection in people living with HIV: the clinical management of gastrointestinal opportunistic infections 2020

“…Persistent or recurrent oesophageal candidiasis has decreased in the cART era and most often indicates poor HIV viral control [3]. Candidiasis of the upper GI tract is discussed in detail in a separate chapter of the BHIVA guidelines on the management of opportunistic infection in people living with HIV: The clinical management of Candidiasis 2019 [4].…”

“…Further discussion of the treatment of candidiasis can be found in the candidiasis chapter of the BHIVA guidelines on the management of opportunistic infection in PLWH [4]. Foscarnet 90 mg/kg bd iv may be used in cases of ganciclovir‐resistant CMV or 40 mg/kg bd or tds for aciclovir‐resistant HSV [10].…”

British HIV Association guidelines on the management of opportunistic infection in people living with HIV: The clinical management of Candidiasis 2019

“…In Dockrell et al [1], the authors would like to correct the following errors. The ‘British Infection Association’ should have been removed from the article title as the BHIVA opportunistic infection guidelines are no longer co‐badged with the British Infection Association.…”