Cartledge JD, Midgley J, Youle M, Fisher M, Gazzard BG; International Conference on AIDS.
Int Conf AIDS. 1993 Jun 6-11; 9: 55 (abstract no. WS-B12-2).
Westminster/St Stephen's HIV Unit, London, UK.
AIM: To retrospectively evaluate ITR-SOL in HIV antibody positive patients with unresponsive oral (OC) and esophageal (EC) candidiasis. METHODS: All recipients of ITR-SOL were identified from pharmacy records and their notes reviewed together with the results of antifungal susceptibilities performed on their candida isolates. RESULTS: Nineteen patients with AIDS (mean CD4 count 22/mm3) with unresponsive candidiasis received Itr-sol. Susceptibility tests were performed on pre-Itr-sol isolates from 14, and reported as sensitive (S)/reduced sensitivity (Red)/resistant (R) to fluconazole (FLU); (R:9; Red:5; S:0); itraconazole capsules (ITR-CAPS); (R:0; Red:5; S:10); and ketoconazole (KET); (R:4; Red:7; S:3). In the preceding month, 17 had failed to respond to FLU, of whom 10 responded to ITR-SOL; 8 had failed with ITR-CAPS, of whom 4 responded to ITR-SOL; and 5 had failed with KET, of whom 3 responded to ITR-SOL. Overall 6.2% with OC and 64% with EC responded to ITR-SOL, doses of 100mg bd and 200mg bd being equally effective. Factors known to impair ITR bioavailability were present in 3 of the 5 non-responders. As secondary prophylaxis, 200mg bd maintained a longer relapse free interval than 100mg bd (p < 0.01). Adverse events were uncommon at these doses (1 case: elevated transaminases). CONCLUSIONS: ITR-SOL was effective and well tolerated. Although resistant isolates were obtained from most FLU non-responders, this was not true of those failing with ITR, where impaired bioavailability may be more important.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antifungal Agents
- Biological Availability
- CD4 Lymphocyte Count
- Candida
- Candidiasis
- Capsules
- Chemistry, Pharmaceutical
- Cyclodextrins
- Esophageal Diseases
- Fluconazole
- HIV Infections
- Humans
- Itraconazole
- Ketoconazole
- Sjogren's Syndrome
Other ID:
UI: 102205517
From Meeting Abstracts