Thrush Can Be Prevented in Patients With Acquired Immunodeficiency Syndrome and the Acquired Immunodeficiency Syndrome—Related Complex

Stevens, David A.

doi:10.1001/archinte.1991.00400120096018

Cited by 53 publications

(9 citation statements)

References 26 publications

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“…The effectiveness of prophylaxis for the prevention of recurrent oral candidiasis has most frequently been demonstrated in patients with HIV [63]. In these patients, fluconazole prophylaxis has been shown to reduce recurrence as compared with no treatment or placebo [64][65][66][67][68]. However, there is concern that continuous treatment may lead to fluconazole resistance.…”

Section: Treatment Of Oral Candidiasismentioning

confidence: 99%

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Armstrong

Blauvelt

Mrowietz

et al. 2022

Dermatol Ther (Heidelb)

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Plaque psoriasis is an immune-mediated inflammatory skin disease associated with the dysregulation of cytokines, especially those involved in the interleukin (IL)-23/IL-17 pathways. In recent years, there has been growing interest in developing biologic therapies that target these pathways. However, inhibition of the cytokines of the IL-23/IL-17 pathways may increase patients' risk of developing fungal infections, particularly oral candidiasis. Therefore, it is important that dermatology practitioners can effectively diagnose and treat oral candidiasis. In this review, we examine the role of the IL-23/IL-17 pathways in antifungal host defense, and provide a practical guide to the diagnosis and treatment of oral candidiasis in

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Section: Treatment Of Oral Candidiasismentioning

confidence: 99%

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Armstrong

Blauvelt

Mrowietz

et al. 2022

Dermatol Ther (Heidelb)

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“…The new triazole fluconazole (FCZ) has proven to be highly effective against oral candidosis in clinical trials (3,6,9,14,16,43), with only low levels of toxicity when given at various dosages and with even higher response rates to treatment than other antifungal agents, e.g., ketoconazole and clotrimazole (5,15,19). Since 1989 fluconazole has widely been used for the prevention and therapy of OPC in HIV-infected patients (14,21,25,26,39). Some earlier reports have already described azole resistance in Candida species (17,30,38,44), but recently, concerns have been raised regarding the development of resistance to FCZ in C. albicans strains isolated from AIDS patients.…”

mentioning

confidence: 99%

Emergence of fluconazole-resistant strains of Candida albicans in patients with recurrent oropharyngeal candidosis and human immunodeficiency virus infection

et al. 1994

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After repeated use of fluconazole for therapy of oropharyngeal candidosis, the emergence of in vitro fluconazole-resistant Candida albicans isolates (MIC, 2 25 ,ig/ml) together with oral candidosis unresponsive to oral dosages of up to 400 mg of fluconazole were observed in patients with human immunodeficiency virus (H1V) infection. Antifungal susceptibility testing was done by broth microdilution and agar dilution techniques on C. albicans isolates recovered from a cohort of patients with symptomatic HIV infection who were treated repeatedly with fluconazole for oropharyngeal candidosis. In vitro findings did show a gradual increase in the MICs for C. albicans isolates recovered from selected patients with repeated episodes of oropharyngeal candidosis. Primary resistance of C. albicans to fluconazole was not seen. Cross-resistance in vitro occurred between fluconazole and other azoles (ketoconazole, itraconazole), but to a lesser extent. The results of the study suggest that the development of clinical resistance to fluconazole could be clearly correlated to in vitro resistance to fluconazole. Itraconazole may still serve as an effective antifungal agent in patients with HIV infection and oropharyngeal candidosis nonresponsive to fluconazole.

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“…31,35 After several recurrences of symptomatic OPC in patients with AIDS, clinicians may prescribe maintenance (secondary) prophylaxis. Fluconazole 100 mg/day had a protective effect in preventing OPC in these patients 61 ; however, the most appropriate longterm strategy has not been thoroughly investigated. Intermittent and continuous antifungal regimens have to be compared to establish the best drug and dosage that will select least for resistant strains of Candida.…”

Section: Antifungal Prophylaxismentioning

confidence: 96%

Options for the Management of Mucosal Candidiasis in Patients with AIDS and HIV Infection

Vázquez

1999

Pharmacotherapy

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Oropharyngeal candidiasis may be the first manifestation of human immunodeficiency viral (HIV) infection, and more than 90% of patients with the acquired immunodeficiency syndrome (AIDS) develop the disease. Although numerous antifungal agents are available, azoles, both topical (clotrimazole) and systemic (fluconazole, itraconazole), have largely replaced older topical antifungals (gentian violet, nystatin) in the management of the disease in these patients. A concern in these patients is clinical relapse, which appears to be dependent on degree of immunosuppression and is more common with clotrimazole and ketoconazole than with fluconazole or itraconazole. Candida esophagitis is also of concern, since it occurs in more than 10% of patients with AIDS. Fluconazole is an integral part of management. A cyclodextrin oral solution formulation of itraconazole has similar clinical response rates as fluconazole and is an effective alternative. In patients with fluconazole-resistant mucocutaneous candidiasis, treatment options include itraconazole and amphotericin B oral suspension and parenteral preparation.

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Thrush Can Be Prevented in Patients With Acquired Immunodeficiency Syndrome and the Acquired Immunodeficiency Syndrome—Related Complex

Cited by 53 publications

References 26 publications

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Emergence of fluconazole-resistant strains of Candida albicans in patients with recurrent oropharyngeal candidosis and human immunodeficiency virus infection

Options for the Management of Mucosal Candidiasis in Patients with AIDS and HIV Infection

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