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Original ArticleOpen Access
Clinical and Mycological Responses to Fluconazole and Fluconazole MIC in Oropharyngeal Candidiasis in HIV-Infected Patients
Bussaratid V 
,
Phonrat B ,
Tansupasawasdikul S ,
Howe P ,
Simpson A ,
White NJ ,
Pitisuttithum P
,
Phonrat B ,
Tansupasawasdikul S ,
Howe P ,
Simpson A ,
White NJ ,
Pitisuttithum P BENJALUCK PHONRAT, M.Sc.*,
PAUL HOWE, M.Sc.***,
NICHOLAS J WHITE, M.D.***
Introduction : OPC is a common opportunistic infection in HIV -infected patients. Although
some patients are asymptomatic, progression of the disease may occur leading to esophageal candidia-
sis. Fluconazole resistant candidiasis has been reported in several international studies.
Objectives : This study aimed to test the MICs (minimal inhibitory concentrations) to
fluconazole of
Candida
species isolated from mouthwash specimens of 54 HIV positive patients with
oral candidiasis. Clinical and mycological responses to fluconazole were also assessed in 16 patients.
Material and Method : This was a prospective study. Mouthwash specimens were cultured
on sabouraud dextrose agar twice.
Candida
species identification was performed and MICs for fluco-
nazole were obtained using NCCLS guidelines. Clinical and mycological responses were assessed on
day 14 and 42 in 16 patients who received a 14-day course of fluconazole.
Results : 48/54 patients (88.89%) were found to carry pure
C. albicans.
The other 6 patients
( 11.11%) had mixed
Candida
species on cultures. Among these 6 patients, 5 patients had mixed
C.
albicans
and
C. glabrata,
and 1 patient had
C. albicans
and
C. krusei.
Fluconazole MICs of
C.
albicans, C. glabrata,
and
C.
krusei
ranged from 0.125-32 (median=0.250), 4-64 (median=2), and 8
giL respectively. This study showed that the MICs to fluconazole of oropharyngeal
Candida
was a
good predictor of the therapeutic responses.
Key word : Oropharyngeal Candidiasis, HIV Infection
PAUL HOWE, M.Sc.***,
NICHOLAS J WHITE, M.D.***
Introduction : OPC is a common opportunistic infection in HIV -infected patients. Although
some patients are asymptomatic, progression of the disease may occur leading to esophageal candidia-
sis. Fluconazole resistant candidiasis has been reported in several international studies.
Objectives : This study aimed to test the MICs (minimal inhibitory concentrations) to
fluconazole of
Candida
species isolated from mouthwash specimens of 54 HIV positive patients with
oral candidiasis. Clinical and mycological responses to fluconazole were also assessed in 16 patients.
Material and Method : This was a prospective study. Mouthwash specimens were cultured
on sabouraud dextrose agar twice.
Candida
species identification was performed and MICs for fluco-
nazole were obtained using NCCLS guidelines. Clinical and mycological responses were assessed on
day 14 and 42 in 16 patients who received a 14-day course of fluconazole.
Results : 48/54 patients (88.89%) were found to carry pure
C. albicans.
The other 6 patients
( 11.11%) had mixed
Candida
species on cultures. Among these 6 patients, 5 patients had mixed
C.
albicans
and
C. glabrata,
and 1 patient had
C. albicans
and
C. krusei.
Fluconazole MICs of
C.
albicans, C. glabrata,
and
C.
krusei
ranged from 0.125-32 (median=0.250), 4-64 (median=2), and 8
giL respectively. This study showed that the MICs to fluconazole of oropharyngeal
Candida
was a
good predictor of the therapeutic responses.
Key word : Oropharyngeal Candidiasis, HIV Infection
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