Chave JP, Vernazza P, Nargalith D, Glanser NP; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 469 (abstract no. Th.B.P.319).
Division of Infections Diseases, St. Galles, Switzerland
OBJECTIVE: Oesophageal candidiasis is a frequent complication of symptomatic HIV infection. In this setting, topicals are ineffective, clinical resistance to ketoconazole is common, and amphotericin is poorly tolerated. Moreover, zidovudine has to be stopped (or can not be initiated) because of side-effects potentiation. In this context, the pharmacokinetic properties of fluconazole (a novel bis-triazole antifungal agent), such as a good oral absorption and a long plasma half-life, are of special interest. METHODS: Eleven adults with a biopsy-documented candidal esophagitis have received a single oral 400 mg fluconazole dose as sole treatment and have been seen again on days 3 and 7. The therapeutic response was ascertained in all cases by a second esophagoscopy on day 7, with cultures and biopsy of any lesion. RESULTS: On day 3, dysplasia was still present in 1/11 patient, who received a second 400 mg dose. Symptoms had disappeared in all patients on day 7, and endoscopic examination was normal in 10/11 cases. One patient presented persisting endoscopic inflammatory signs, but with no evidence of fungi on biopsy and culture. One other patient relapsed 41 days later (follow-up: 9-259 days, median 114 days). Transitory headache and nausea have been observed in one patient 6 hours after fluconazole ingestion. No other subjective side effect and no hepatic, renal or hematologic signs have been recorded. CONCLUSION: These preliminary results suggest that a single oral dose of fluconazole may cure esophageal candidiasis and is well tolerated. This treatment ensures optimal drug compliance and could avoid hospitalization and/or Zidovudine interruption in patients with AIDS.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adult
- Amphotericin B
- Antifungal Agents
- Candidiasis
- Esophagitis
- Esophagoscopy
- Fluconazole
- Fungi
- Humans
- Ketoconazole
- Pilot Projects
- Single Person
- Triazoles
- Zidovudine
- therapy
Other ID:
UI: 102178329
From Meeting Abstracts