CLINICAL-PARAMETERS ASSOCIATED WITH RECALCITRANT ORAL CANDIDOSIS IN HIV-INFECTION - A PRELIMINARY-STUDY

Clinical resistance in oropharyngeal candidosis is an increasingly sig nificant management problem in HN-seropositive patients. This study wa s undertaken to identify predisposing risk factors including the isola tion of particular species of Candida which may be associated with the development of clinical resistance. The effect of particular antifung al prescribing regimens was also assessed. Data were compiled by chart review of 2 groups, each of 10 HIV-seropositive CDC stage IV patients with recurrent oropharyngeal candidosis. All patients had swabs taken at intervals during treatment and all candida isolates were species t yped. The patients in group 1 exhibited candida infections which did n ot respond clinically to standard therapeutic regimens. The second pat ient group did respond to standard oral antifungal therapies. An assoc iation was found between the frequent utilization of azoles, particula rly fluconazole and the development of clinically resistant oral candi dosis. The number of candida isolates grown from the initial swab was also significantly related to the development of resistance.