CORRELATION BETWEEN IN-VITRO RESISTANCE TO FLUCONAZOLE AND CLINICAL OUTCOME OF OROPHARYNGEAL CANDIDIASIS IN HIV-INFECTED PATIENTS

Fifty episodes of oropharyngeal candidiasis in HIV-infected patients w ere analyzed prospectively in order to evaluate the clinical response to fluconazole. The minimum inhibitory concentrations (MICs) of flucon azole for the Candida strains isolated from the pharynx were correlate d with the clinical response, Treatment with fluconazole (100 mg/day) was successful in 86% of the cases, A good clinical outcome followed i n 97% of the cases when a strain sensitive to fluconazole was isolated . This figure fell to 22% when the strain was resistant to fluconazole (p<0.001). The rate of post-treatment colonization was high (87%), an d selection of non-albicans Candida species occurred in 23% of the cas es, In conclusion, fluconazole treatment for oropharyngeal candidiasis of HIV-infected patients was useful in most cases, but less sensitive non-albicans species can be selected, Most treatment failures were as sociated with increased MICs of fluconazole for the strains isolated b efore treatment; therefore, susceptibility testing is recommended as a n aid in clinical decision-making for the use of the azole group of dr ugs.