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A systematic review of the management of oral candidiasis associated with HIV/AIDS.

Abstract
The purpose of this review was to investigate the management of oral candidiasis in HIV/AIDS patients and to evaluate the different guidelines available for its management. A number of topical and systemic antifungal medications are used to treat oral candidiasis in HIV-positive patients. Milder episodes of oral candidiasis respond to topical therapy with nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better cure rates or better prevention of relapse. Intravenous amphotericin B has been found to be effective in azole-refractory candidiasis and is well tolerated. Topical therapies are effective for uncomplicated oropharyngeal candidiasis; however, patients relapsed more quickly than those treated with oral systemic antifungal therapy. Nystatin appeared less effective than clotrimazole and the azoles in the treatment of oropharyngeal candidiasis. Clotrimazole was found to be just as effective for resolution of clinical symptoms as the azoles, except when patient compliance was poor. Fluconazole-treated patients were more likely to remain disease-free during the fluconazole follow-up period than those treated with other antifungal agents.
AuthorsH A Albougy, S Naidoo
JournalSADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging (SADJ) Vol. 57 Issue 11 Pg. 457-66 (Dec 2002) ISSN: 1029-4864 [Print] South Africa
PMID12674866 (Publication Type: Journal Article, Review, Systematic Review)
Chemical References
  • Antifungal Agents
  • Triazoles
Topics
  • AIDS-Related Opportunistic Infections (epidemiology)
  • Acquired Immunodeficiency Syndrome (epidemiology)
  • Antifungal Agents (therapeutic use)
  • Candidiasis, Oral (classification, diagnosis, drug therapy, epidemiology)
  • Comorbidity
  • HIV Infections (epidemiology)
  • Humans
  • Practice Guidelines as Topic
  • Treatment Outcome
  • Triazoles (therapeutic use)

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