Fluconazole in the management of oropharyngeal candidosis in a predominantly HIV antibody-positive group of patients

Dupont, B.; Drouhet, E.

doi:10.1080/02681218880000081

Cited by 119 publications

(44 citation statements)

References 4 publications

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“…The introduction of the orally active azole antifungals ketoconazole and fluconazole has produced dramatic improvements in the management of the condition in immunocompromised patients (Fazio et al, 1983 ;Dupont & Drouhet, 1988;Epstein, 1990;Larsen, 1990;Hay, 1991). However, even with these drugs, protracted treatment is necessary if remission of infection is to be achieved and sustained (Esposito et al, 1990;Leen et al, 1990;Larsen, 1990).…”

Section: Discussionmentioning

confidence: 99%

Reduced azole susceptibility of oral isolates of Candida albicans from HIV-positive patients and a derivative exhibiting colony morphology variation

Gallagher

Bennett

Henman

et al. 1992

Journal of General Microbiology

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Approximately 50 % (15/28) of a selection of oral isolates of Candida albicuns from separate individuals infected with the human immunodeficiency virus (HIV) exhibited low susceptibility to ketoconazole as determined by hyphal elongation assessment. Nine of these isolates exhibited colony morphology variation or switching at 37 "C, of which six expressed low ketoconazole susceptibility. To determine whether colony morphology variation could give rise to derivatives with reduced azole susceptibility, several high-frequency switching variants of three HIVpatient isolates were recovered and assessed. All but one of the variants expressed similar azole susceptibility profiles to their respective parental strains. However, the C. albicans derivative 132ACR expressed significantly reduced susceptibility to ketoconazole in comparison to its parental strain 132A. In whole cells, on the basis of total growth the switched derivative 132ACR was markedly less susceptible than its parental isolate 132A to ketoconazole at 10 p~. A much smaller difference was observed with fluconazole at 10 PM, with the switched derivative 132ACR exhibiting a threefold lower susceptibility compared with the parental isolate 132A. The incorporation of [14C]acetate in control and azole-treated cells of both organisms was higher for the parental strain. When cell lysates of strain 132A and its derivative 132ACR were incubated with 114C]mevalonic acid and ketoconazole, the IC,, for 14C-label incorporation into 63-4 demethyl sterols was fivefold higher for lysates of the . switched derivative 132ACR compared with those of the parental strain 132A. With fluconazole the IC5,, value for the derivative 132ACR was 25-fold higher than for strain 132A. The 14-sterol demethylase of the switched derivative 132ACR was possibly less sensitive to azole inhibition than that of the enzyme of strain 132A. These studies indicated that colony morphology variation in vifro can generate derivatives with stable, reduced azole susceptibility without prior exposure to azoles.

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Section: Discussionmentioning

confidence: 99%

Reduced azole susceptibility of oral isolates of Candida albicans from HIV-positive patients and a derivative exhibiting colony morphology variation

Gallagher

Bennett

Henman

et al. 1992

Journal of General Microbiology

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“…Some of this information is given below. The high systemic absorption of fluconazole has been useful in treating oral candidosis in HIV-infected patients, and it is now considered the drug of choice for candidoses in HIV disease (Dupont and Drouhet, 1988;Lucatorto et al, 1991). It has been shown that weekly fluconazole (200 mg) is safe and effective in preventing oropharyngeal and vaginal candidosis, and this regimen has a useful role in the management of HIV-infected patients who are at risk for recurrent mucosal candidosis (Schuman et al, 1997).…”

Section: (F) Median Rhomboid Glossitismentioning

confidence: 99%

Oral Candidal Infections and Antimycotics

Ellepola

Samaranayake

2000

Critical Reviews in Oral Biology & Medicine

210

236

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The advent of the human immunodeficiency virus infection and the increasing prevalence of compromised individuals in the community due to modern therapeutic advances have resulted in a resurgence of opportunistic infections, including oral candidoses. One form of the latter presents classically as a white lesion of "thrush" and is usually easily diagnosed and cured. Nonetheless, a minority of these lesions appears in new guises such as erythematous candidosis, thereby confounding the unwary clinician and complicating its management. Despite the availability of several effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. This problem has been partly circumvented by the introduction of the triazole agents, which initially appeared to be highly effective. However, an alarming increase of organisms resistant to the triazoles has been reported recently. In this review, an overview of clinical manifestations of oral candidoses and recent advances in antimycotic therapy is given, together with newer concepts, such as the post-antifungal effect (PAFE) and its possible therapeutic implications.

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“…Two studies on the efficacy of fluconazole in the treatment of oropharyngeal candidiasis in compromised patients have been reported (78,189). In one noncomparative study, fluconazole (50 mg) was administered orally once daily to a group of 63 patients with oropharyngeal candidiasis, 55 of whom tested positive for the human immunodeficiency virus antibody (78).…”

Section: Antifungal Imidazoles Under Developmentmentioning

confidence: 99%

“…In one noncomparative study, fluconazole (50 mg) was administered orally once daily to a group of 63 patients with oropharyngeal candidiasis, 55 of whom tested positive for the human immunodeficiency virus antibody (78). Daily therapy ranged from 5 to 20 days and was followed by alternate-day maintenance therapy.…”

Section: Antifungal Imidazoles Under Developmentmentioning

confidence: 99%

Overview of medically important antifungal azole derivatives

1988

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Fungal infections are a major burden to the health and welfare of modern humans. They range from simply cosmetic, non-life-threatening skin infections to severe, systemic infections that may lead to significant debilitation or death. The selection of chemotherapeutic agents useful for the treatment of fungal infections is small. In this overview, a major chemical group with antifungal activity, the azole derivatives, is examined. Included are historical and state of the art information on the in vitro activity, experimental in vivo activity, mode of action, pharmacokinetics, clinical studies, and uses and adverse reactions of imidazoles currently marketed (clotrimazole, miconazole, econazole, ketoconazole, bifonazole, butoconazole, croconazole, fenticonazole, isoconazole, oxiconazole, sulconazole, and tioconazole) and under development (aliconazole and omoconazole), as well as triazoles currently marketed (terconazole) and under development (fluconazole, itraconazole, vibunazole, alteconazole, and ICI 195,739).

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Fluconazole in the management of oropharyngeal candidosis in a predominantly HIV antibody-positive group of patients

Cited by 119 publications

References 4 publications

Reduced azole susceptibility of oral isolates of Candida albicans from HIV-positive patients and a derivative exhibiting colony morphology variation

Reduced azole susceptibility of oral isolates of Candida albicans from HIV-positive patients and a derivative exhibiting colony morphology variation

Oral Candidal Infections and Antimycotics

Overview of medically important antifungal azole derivatives

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