Drugs

, Volume 47, Issue 5, pp 734–740 | Cite as

Treatment of Oral Candida Mucositis Infections

  • Gary E. Garber
Practical Therapeutics

Summary

Infections due to Candida spp. are increasing in incidence as the number of immune compromised patients increases. The common presentation of Candida mucositis and oral infections includes atrophic candidiasis, angular cheilitis, leukoplakia and oesophagitis. An increasing spectrum of antifungal agents, including imidazoles, are available for treatment and suppression of this common infection. In chronically immune-compromised patients such as those with severe HIV related immune deficiency, eradication of the infection may not be possible. This requires a stepwise approach to management and may require the use of potent, toxic agents such as amphotericin B to suppress the symptoms and signs of infection sufficiently to provide the patient with symptomatic relief. Resistant organisms are also becoming a greater problem in this patient population.

Keywords

Fluconazole Candidiasis Ketoconazole Antifungal Therapy Nystatin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bonacini M, Young T, Laine L. The causes of esophageal symptoms in human immunodeficiency virus infection: a prospective study of 110 patients. Archives of Internal Medicine 151: 1567–1572, 1991PubMedCrossRefGoogle Scholar
  2. Crislip MA, Edwards Jr JE. Candida albicans and related species. In Gorbach et al. (Eds) Infectious diseases, pp. 1887–1889, WB Saunders Co., Philadelphia, 1992Google Scholar
  3. DeWit S, Goosens H, Weerts D, Clumeck N. Comparison of fluconazole and ketoconazole for oropharyngeal candidiasis in AIDS. Lancet 1: 746–748, 1989CrossRefGoogle Scholar
  4. Edwards Jr JE. Candida species. In Mandell et al. (Eds) Principles and practice of infectious disease, pp. 1943–1949, Churchill Livingstone Inc., New York, 1990Google Scholar
  5. Koletar SL, Russell JA, Fass RJ, Plouffe JF. Comparison of oral fluconazole and clotrimazole troches as treatment for oral candidiasis in patients infected with HIV. Antimicrobial Agents and Chemotherapy 34: 2267–2268, 1990PubMedCrossRefGoogle Scholar
  6. Kowalsky SF, Dixon DM. Fluconazole: a new antifungal agent. Clinical Pharmacy 10: 179–194, 1991PubMedGoogle Scholar
  7. Laine L, Conteus C, Islam MZ, et al. Prospective randomised double blind trial of fluconazole vs ketoconazole for Candida esophagitis. Gastroenterology 100: A591, 1990Google Scholar
  8. Laine L, Dretler RH, Conteas CN, et al. Fluconazole compared with ketoconazole for the treatment of Candida esophagitis in AIDS. Annals of Internal Medicine 117: 655–660, 1992PubMedGoogle Scholar
  9. Lake-Bakaar G, Tom W, Lake-Bakaar D, et al. Gastropathy and ketoconazole malabsorption in AIDS. Annals of Internal Medicine 109: 471–473, 1988PubMedGoogle Scholar
  10. Marriott DJE, Jones PD, Hoy JF, Speed BR, Harkness JL. Fluconazole once a week as secondary prophylaxis against oropharyngeal candidiasis in HIV infected patients. Medical Journal of Australia 158: 312–316, 1993PubMedGoogle Scholar
  11. McCloskey R, Hathorn J, Buell DN. Fluconazole vs. clotrimazole treatment of oropharyngeal candidiasis in adults with malignancy. Proceedings of the 30th Interscience Conference on Antimicrobial Agents and Chemotherapy Meeting, October 21-24,1990, Atlanta, Georgia, Abstract #1280,1990 Americal Society for Microbiology, Washington, DC, 1990Google Scholar
  12. Petersen EA, Alling DW, Kirkpatrick CH. Treatment of chronic mucocutaneous candidiasis with ketoconazole. Annals of Internal Medicine 93: 791–795, 1980PubMedGoogle Scholar
  13. Powderly WG, Saag MS, Cloud GA, et al. Controlled trial of fluconazole or amphotericin-B to prevent relapse of cryptococcal meningitis in patients with AIDS. New England Journal of Medicine 326: 793–798, 1992PubMedCrossRefGoogle Scholar
  14. Shepp DH, Klosterman A, Siegel SM, et al. Comparative trial of ketoconazole and nystatin for the prevention of fungal infection in neutropenic patients treated in a protective environment. Journal of Infectious Diseases 152: 1257–1263, 1985PubMedCrossRefGoogle Scholar
  15. Smith DE, Midgley J, Allan M, et al. Itraconazole vs ketoconazole in the treatment of oral and esophageal candidiasis in patients infected with HIV. AIDS 5: 1367–1371, 1991PubMedCrossRefGoogle Scholar
  16. Thorsen S, Mathiesen LR. Fluconazole for ketoconazole resistant oropharyngeal candidiasis in HIV-1 infected patients. Scandinavian Journal of Infectious Disease 22: 275–276, 1990CrossRefGoogle Scholar
  17. Wingard JR, Merz WG, Rinaldi MG, et al. Increase in Candida krusei among patients with transplantation and neutropenia treated prophylactically with fluconazole. New England Journal of Medicine 325: 1274–1277, 1991PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Gary E. Garber
    • 1
  1. 1.Division of Infectious DiseasesOttawa General Hospital, University of OttawaOttawaCanada

Personalised recommendations