title: Relative growth measurement of Candida species in a single concentration of fluconazole predicts the clinical response to fluconazole in HIV infected patients with oral candidosis.
abstract: The growth of 113 Candida spp. isolated prospectively from 104 HIV-positive patients treated for thrush was determined using a single concentration of 3 mg/L (10(-5) M) fluconazole relative to growth in drug free medium. Using a receiver operator characteristic curve, a relative growth in fluconazole of > or = 88% best discriminated between isolates from 56 patients who responded to treatment with fluconazole and 48 who failed to respond to 7 days, treatment with at least 100 mg/d drug with a sensitivity of 98% and a specificity of 96%. When the isolates from the eight patients with mixed infections due to both resistant and susceptible yeasts were excluded, the sensitivity and specificity both reached 100%. Relative growth of Candida spp. in a single concentration of fluconazole can therefore be used to accurately predict the clinical response to standard fluconazole treatment of thrush in patients infected with HIV.
authors.affiliation: Department of HIV/Genito-urinary Medicine, Chelsea & Westminster Health Care Trust, London, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Cartledge
authors.forename: J
authors.initials: J
authors.lastname: Midgley
authors.forename: B G
authors.initials: BG
authors.lastname: Gazzard
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects* / Q000254:growth & development; D002180:Candidiasis, Oral / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D004935:Esophageal Diseases / Q000188:drug therapy; D005069:Evaluation Studies as Topic; D015725:Fluconazole / Q000494:pharmacology* / Q000627:therapeutic use; D006679:HIV Seropositivity; D006801:Humans; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole