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.


METHODS
A prospective, single center, open-labeled study.


METHODS
A university-based inner-city HIV/AIDS clinic.


METHODS
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.


METHODS
Patients were given 15 ml melaleuca oral solution four times daily to swish and expel for 2-4 weeks.


METHODS
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.
Jandourek
A
A
Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Vaishampayan
J K
JK
Vazquez
J A
JA
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000188:drug therapy* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D011446:Prospective Studies; D013662:Tea; D017211:Treatment Failure; D016896:Treatment Outcome
D000935:Antifungal Agents; D009067:Mouthwashes; D013662:Tea; D015725:Fluconazole