Resistance of gastrointestinal candidiasis to fluconazol and itraconazol in a patient with AIDS

Tebbe B., BOYVAT A., Geilen C., Wolfer L., Seibold M., Orfanos C.

HAUTARZT, cilt.47, sa.2, ss.136-139, 1996 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 47 Sayı: 2
  • Basım Tarihi: 1996
  • Doi Numarası: 10.1007/s001050050391
  • Dergi Adı: HAUTARZT
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.136-139
  • Anahtar Kelimeler: fluconazole resistance, itraconazol resistance, Candidiasis, HIV infection, AIDS, HUMAN-IMMUNODEFICIENCY-VIRUS, INVITRO SUSCEPTIBILITY, FUNGAL-INFECTIONS, ORAL CANDIDOSIS, AMPHOTERICIN-B, ALBICANS, KETOCONAZOLE, GLABRATA
  • Ankara Üniversitesi Adresli: Hayır

Özet

We report on a 32-year-old male patient with advanced acquired immunodeficiency syndrome (AIDS), who had severe candidiasis of the gastrointestinal tract. Treatment with fluconazole, 200 mg/day, was introduced. After oral intake of fluconazole over 5 months itraconazole 200 mg/day was given for 1 month. However, fungal infection still persisted. The antifungal activity of fluconazole, itraconazole and ketoconazole against Candida albicans was evaluated by means of the microdilution test by determining the 90% inhibitory concentrations of each drugs. A high minimal inhibitory concentration (MIG) was detected for fluconazole (50 mu g/ml) revealing fluconazole resistance. The susceptibility to itraconazole was borderline (MIG 0.125 mu g/ml) and that to ketoconazole was markedly lowered (MIG 0.25 mu g/ml). Plasma levels of itraconazole were also found to be lowered. In HIV patients the gastrointestinal absorption of azole derivatives is often reduced. Therefore. the clinical resistance of Candida albicans to itraconazole can be explained by reduced susceptibility after azole therapy and also by the decreased absorption of the drug in HIV patients.