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Resistant candidiasis

W G Powderly1

  • 1Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri 63110.

AIDS Research and Human Retroviruses
|August 1, 1994
PubMed
Summary
This summary is machine-generated.

Fluconazole-resistant mucosal candidiasis is rising in HIV patients. Alternative antifungals like itraconazole or amphotericin B may be needed, but further research on resistance and effective therapies is crucial.

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Area of Science:

  • Mycology
  • Infectious Diseases
  • HIV/AIDS Research

Background:

  • Mucosal candidiasis is a frequent opportunistic infection in individuals with Human Immunodeficiency Virus (HIV).
  • The widespread use of fluconazole for treating or preventing Candida infections in advanced HIV has led to increased recognition of fluconazole-resistant strains.
  • Standardized susceptibility testing and clear clinical correlations for fluconazole resistance remain challenging.

Purpose of the Study:

  • To highlight the growing issue of fluconazole resistance in mucosal candidiasis among HIV-infected patients.
  • To discuss current therapeutic options and their limitations.
  • To emphasize the need for further research into resistance mechanisms, risk factors, and novel treatment strategies.

Main Methods:

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  • Review of existing literature on mucosal candidiasis in HIV.
  • Analysis of clinical observations regarding fluconazole treatment failures.
  • Discussion of in vitro susceptibility data and clinical efficacy of alternative antifungals.

    • Main Results:

    • Clinical resistance to fluconazole in mucosal candidiasis is increasingly observed in patients with advanced HIV.
    • Some patients who fail fluconazole may respond to itraconazole or ketoconazole, though in vitro susceptibility does not guarantee clinical success.
    • Amphotericin B is often effective initially but requires intravenous administration, and relapses are common.

    Conclusions:

    • There is a significant and growing clinical challenge posed by fluconazole-resistant mucosal candidiasis in the HIV population.
    • Current alternative therapies have limitations, including administration routes and potential for treatment failure.
    • Further studies are urgently needed to understand the incidence and risk factors for resistance and to develop more effective and durable treatment options.