ITRACONAZOLE SUSPENSION IN THE TREATMENT OF HIV-INFECTED PATIENTS SUFFERING FROM FLUCONAZOLE-RESISTANT OROPHARYNGEAL AND ESOPHAGEAL CANDIDOSIS

Forty AIDS patients suffering from fluconazole-resistant oropharyngeal candidosis were treated with oral itraconazole solution (200-800 mg/d ay). In 39/49 patients the disease could be initially cured or signifi cantly improved. In contrast to the good clinical results, however, on ly in six patients a yeast count reduction tvas observed, and in four patients unchanged high yeast counts persisted. The main pathogen was C. albicans. Even in longtime treatment itraconazole solution was well tolerated. In two patients only the therapy had to be stopped due to the increase of transaminases. Considerable individual deviations in s erum concentrations of itraconazole or hydroxy-itraconazole, respectiv ely, were observed which correlated only to a minor degree with clinic al and mycological results. Application of itraconazole in a soluble p reparation caused an increase in efficacy due to simultaneous local an d systemic action. In the case of resistance to fluconazole the itraco nazole solution is a valuable alternative to the administration of amp hotericin B which is rich in adverse reactions.