Efficacy of melaleuca oral solution for the treatment of fluconazole refractory oral candidiasis in AIDS patients.
OBJECTIVE: To evaluate the efficacy of melaleuca oral solution in AIDS patients with fluconazole-resistant oropharyngeal candida infections. DESIGN: A prospective, single center, open-labeled study. SETTING: A university-based inner-city HIV/AIDS clinic. PATIENTS: Thirteen patients with AIDS and oral candidiasis documented to be clinically refractory to fluconazole, as defined by failure to respond to a minimum of 14 days of > or = 400 mg fluconazole per day. Additionally, patients had in vitro resistance to fluconazole, defined by minimal inhibitory concentrations of > or = 20 microg/ml. INTERVENTIONS: Patients were given 15 ml melaleuca oral solution four times daily to swish and expel for 2-4 weeks. MAIN OUTCOME MEASURES: Resolution of clinical lesions of oral pseudomembranous candidiasis lesions. Evaluations were performed weekly for 4 weeks and at the end of therapy for clinical signs of oral candidiasis. Quantitative yeast cultures were performed at each evaluation. RESULTS: A total of 13 patients were entered into the study, 12 were evaluable. At the 2-week evaluation, seven out of 12 patients had improved, none were cured, and six were unchanged. At the 4-week evaluation, eight out of 12 patients showed a response (two cured, six improved), four were non-responders, and one had deteriorated. A mycological response was seen in seven out of 12 patients. A follow-up evaluation 2-4 weeks after therapy was discontinued revealed that there were no clinical relapses in the two patients who were cured. CONCLUSIONS: Melaleuca oral solution appears to be effective as an alternative regimen for AIDS patients with oropharyngeal candidiasis refractory to fluconazole.[1]References
- Efficacy of melaleuca oral solution for the treatment of fluconazole refractory oral candidiasis in AIDS patients. Jandourek, A., Vaishampayan, J.K., Vazquez, J.A. AIDS (1998) [Pubmed]
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