Miconazole treatment in candidal oesophagitis

Seven patients with candidal oesophagitis were treated for up to 8 weeks with an intravenous infusion of miconazole, usually 600 mg given over a period of 30-60 minutes with a frequency depending upon the individual patient. As well as oesophagoscopy, biopsy and culture to establish the clinical course of the disease, a series of immunological investigations were performed, to assess the involvement of the patients' immune mechanisms, together with a whole battery of laboratory investigations to assess their response to the drug. A subjective improvement was observed in all patients after periods varying from 3 to 10 days and objective improvements were observed by oesophagoscopy by 5 of the patients in periods of one to four weeks. The same procedure showed 3 patients to have become completely normal after periods of one to three months. Apart from one instance of nausea, no other side-effects and no abnormal laboratory results were seen. It is suggested that the results of treatment depend on the clinical status of the patient, the associated pathology and the underlying immunological disturbance.