TREATMENT OF CANDIDA ESOPHAGITIS WITH FLUCONAZOLE IN ACQUIRED-IMMUNODEFICIENCY-SYNDROME - COMPARATIVE-STUDY OF 2 THERAPEUTIC REGIMENS

BACKGROUND: To evaluate the efficacy and pharmacological safety of 2 therapeutic trials with fluconazole in candida esophagitis in AIDS patients. METHODS: A total of 75 episodes of candida esophagitis in 70 AIDS patients were included in an open prospective study. In group I 36 patients were included who received 200 mg of fluconazole orally the first day followed by 100 mg daily for 4 weeks. In group II (34 patients) the length of treatment was reduced to 10 days with the same daily dosis. Therapeutic response was evaluated by esophagoscopy, biopsy and fungal culture. RESULTS: The protocol was completed at 68 episodes with a cure being obtained in all but 2 patients in group II. No significant differences in clinical response were found between the 2 groups. The incidence of oropharyngeal colonization at the end of treatment was greater in patients from group I than from group II (43 % vs 11 %). Fluconazole was well tolerated in all the patients. A slight alteration of the hepatic enzymes was observed in 29 cases (40 %) with a lower incidence in the shorter time group (p < 0.001), however, treatment was discontinued only in 1 patient because of severe asymptomatic hepatic dysfunction to which a relation with the drug is unclear. CONCLUSIONS: Fluconazole in an efficient and safe agent in the treatment of candida esophagitis in AIDS patients. A 10 day treatment is a useful as longer treatment and has a lower risk of adverse effects.