       Document 0235
 DOCN  M9640235
 TI    Risk factors for fluconazole-resistant candidiasis in human
       immunodeficiency virus-infected patients.
 DT    9604
 AU    Maenza JR; Keruly JC; Moore RD; Chaisson RE; Merz WG; Gallant JE;
       Division of Infectious Diseases, Johns Hopkins University School; of
       Medicine, Baltimore, Maryland 21287-6220, USA.
 SO    J Infect Dis. 1996 Jan;173(1):219-25. Unique Identifier : AIDSLINE
       MED/96132485
 AB    In a case-control study to identify risk factors for
       fluconazole-resistant oroesophageal candidiasis in human
       immunodeficiency virus-infected patients, 25 patients with clinical and
       in vitro fluconazole-resistant candidiasis were paired with controls who
       had treatment-responsive candidiasis and who had been observed for
       similar time periods. After their first episode of candidiasis, patients
       who later developed fluconazole resistance had more treated episodes
       than did matched controls (cases, 3.1; controls, 1.8; P = .004), lower
       median CD4 cell counts (11/mm3 vs. 71/mm/3; P = .004), and greater
       median durations of all antifungal therapy (419 vs. 118 days; P < .001)
       and of systemic azole therapy (272 vs. 14 days; P < .001). When paired
       with a second set of controls matched by CD4 cell count as well as first
       diagnosis of candidiasis, cases continued to show greater median
       exposure to azoles (272 vs. 88 days; P = .005). These data indicate that
       advanced immunosuppression and exposure to oral azoles are risk factors
       for the development of fluconazole resistance.
 DE    Adult  Antifungal Agents/*PHARMACOLOGY  AIDS-Related Opportunistic
       Infections/*DRUG THERAPY/MICROBIOLOGY  Candida/*DRUG EFFECTS/ISOLATION &
       PURIF  Candidiasis, Oral/*DRUG THERAPY/MICROBIOLOGY  Case-Control
       Studies  CD4 Lymphocyte Count  Drug Resistance, Microbial
       Esophagitis/*DRUG THERAPY/MICROBIOLOGY  Female
       Fluconazole/*PHARMACOLOGY  Human  Immune Tolerance  Male  Microbial
       Sensitivity Tests  Risk Factors  Support, U.S. Gov't, P.H.S.  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

