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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

A Journal on Internal Medicine and Pharmacology


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Gazzetta Medica Italiana Archivio per le Scienze Mediche 1999 April;158(2):37-9

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Treatment of oral candidiasis with high dose of itraconazole in AIDS patients. Personal experience

Pellicanò S. 1, Calzone R. 2, Mandica D. 2, Dattola O. L. 1, Terra L. 1

1 Regione Calabria - ASL n. 5, Ospedale S. Giovanni di Dio - Crotone, Divisione di «Malattie Infettive»; 2 Regione Calabria - ASL n. 5, Ospedale S. Giovanni di Dio - Crotone, Dietista


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Background. Micotic infections are a very com-mon pathology in AIDS patients since selective deficit of T4-lymphocytes cause a damage of cellular immunity on oral cavity. Fungal strains can present a primary resistance, characterized by the selection of strains with natural or acquired resistance, for drug-induced genetic modifications. In the last years fluconazole-resistance, a drug used for terapeutic or prophylactic purpose, is an emergent problem in oral candidiasis of HIV positive patients. Objective of this work was to evaluate the clinical efficacy and toxicity of the treatment of oral candidiasis in AIDS patients also with high dose of itraconazole.
Methods. 33 patients with oral candidiasis resistant to fluconazole, with age ranging from 23 to 48 years, were enrolled. 92% of patients was treated with 200-400 mg/die and 8% with 600-1000 mg/die of itraconazole. Mean duration of treatment was 21-210 days (mean 68 days). Moreover the patients received a personal nutritional support.
Results. 95% of patients responded to the treatment. Side effects (30% of patients) were modest without sospension of treatment. Weight increase occurred in 79% of patients (mean +5.9 kg).
Conclusions. This study shows that treatment with itraconazole, also with high dose, is efficacious and well tollerated. Stress is laid on adequate nutritional assistence which should be part of the therapeutic treatment of HIV patients.

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