RESPONSE TO FLUCONAZOLE BY 23 PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND ORAL CANDIDIASIS - PHARMACOLOGICAL AND MYCOLOGICAL FACTORS

The MICs of fluconazole for strains of Candida species and the levels of fluconazole in serum were determined at day 0 and day 14 for 23 hum an immunodeficiency virus-infected patients with oral candidiasis who were treated orally with 100 mg of fluconazole per day for 14 days. Am ong the 23 patients, 11 (48%) were not clinically cured and had persis tent isolation of Candida albicans (n = 10) and/or presence of non-C. albicans (n = 6). Clinical response could be predicted by the suscepti bility of the strain to fluconazole determined at day 0. All 12 patien ts who were cured were infected with a strain for which the MIC was < 0.78 mg/liter. All four patients who were infected with a strain for w hich the MIC was > 3.12 mg/liter experienced clinical failure. These d ata suggest that a C. albicans strain could be defined as being suscep tible when the MIC of fluconazole is < 0.78 mg/liter and as being resi stant when the MIC is > 3.12 mg/liter.