THE OSTIA VENAE HEPATICAE AND THE RETHROHEPATIC ...

COMPARATIVE TREATMENT OF ORAL CANDIDIASIS IN AIDS
PATIENTS WITH CLOTRIMAZOLE TROCHES AND ITRACONAZOLE
ORAL SOLUTION
Rumpa Linpiyawan 1 , Kitti Jittreprasert 2 , Apichati Sivayathorn 1
1 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University and
2 Bumrajnaradura Hospital.
Key words : Candidiasis, Clotrimazole, Itraconazole, AIDS
Objective : To compare the efficacy and safety of itraconazole versus clotrimazole
troche in the treatment of oropharyngeal candidiasis in AIDS patients.
Methods and Patients : All HIV-infected patients who visit our clinic with confirmed
oropharyngeal candidiasis were randomly, observer-blind treated with clotrimazole troches (10 mg, 5
times daily) or Itraconazole oral solution (10 mg/15 ml twice daily), each for 1 week. Clinical follow up
and mycological assessment were carried out on 4 consecutive days, 1, 2 and 4 weeks after the start of
treatment was done. Clinical cure was defined as resolution of all signs and symptoms. Mycological cure
was defined as negative result in both KOH preparation and fungal culture. Combined clinical and mycological
efficacy were used for global evaluation. Relapses were defined as renewed signs and symptoms with
either a positive KOH examination or culture.
Results : Of the 29 patients, 15 were treated with clotrimazole troches (group I) and 14
with itraconazole oral solution (group II). Both groups were comparable in age, sex, episodes of occurrence,
mean clinical severity scores before treatment and the mean CD4 cell counts. We observed global evaluation
as cure in 73.33% (group I) vs 66.7% 9group II) (p=0.806) of patients by the end of 1 week
treatment. The relapse rate at 2 wk was 38.5% vs 16.7% (p=0.301) and the relapse rate at 4 wk was
62.5% vs 33.3% (p=0.347) for group I and II, respectively. The clinical efficacy & mycological cure were
not significantly different between both groups throughout the study. No any adverse effects were reported
in both groups.
Conclusion : Both drugs were effective and safe agents in the treatment of oral candidiasis
in AIDS. The relapse rates were also not statistically different.
(Presented at the Annual Meeting of the Dermatological Society of Thailand, Bangkok, Thailand,
4-5 March 1999)
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