Efficacy of fluconazole and itraconazole in the treatment of oral candidiasis in HIV patients

A total of 46 strains of Candida were collected from HIV infected patients, of which 25 strains were isolated from patients with oral candidiasis, and 21 strains were from mouthwash samples of asymptomatic carriers. The most common species isolated was Candida albicans (73.9%), followed by Candida t ropicalis (21.7%). In vitro susceptibility of the strains to fluconazole an d itraconazole was tested using minimum inhibitory concentration (MIQ studi es by agar dilution technique. Out of the 18 strains of C. albicans isolate d from mouthwash samples, four were resistant to fluconazole whereas only t wo were resistant to itraconazole. Out of 16 strains of C. albicans isolate d from oral lesions, one was resistant to fluconazole where as all were sen sitive to itraconazole. Among the other species of Candida tested, C. tropi calis gave higher MIC values to both drugs than other species such as Candi da guillermondii and Candida krusei. In vitro MIC values correlated well wi th in vivo responses in patients. Hence, itraconazole may be used as an alt ernative in the treatment of candidiasis, which does not respond to flucona zole therapy. (C) 2001 Elsevier Science BN. All rights reserved.