A comparison of fluconazole oral suspension and amphotericin B oral suspension in older patients with oropharyngeal candidosis
| Autor: | M Alemanni, J Taillandier, Y Esnault |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Aging
medicine.medical_specialty business.industry General Medicine Buccal administration Gastroenterology law.invention Surgery Clinical trial Nystatin Pharmacotherapy Randomized controlled trial law Amphotericin B Internal medicine medicine Geriatrics and Gerontology business Adverse effect Fluconazole medicine.drug |
| Zdroj: | Age and Ageing. 29:117-123 |
| ISSN: | 1468-2834 |
| DOI: | 10.1093/ageing/29.2.117 |
| Popis: | Background: the optimum treatment for oropharyngeal candidosis, particularly in older patients, has not been established. Local treatment with nystatin and amphotericin B can be problematic. The oral suspension formulation of fluconazole may offer a good alternative to these conventional agents. Objective: to compare the safety and efficacy of fluconazole oral suspension with amphotericin B oral suspension in the treatment of older patients with oropharyngeal candidosis. Design: randomized open-label study. Patients: three hundred and five patients, aged 62 or older, with at least one sign or symptom of oropharyngeal candidosis. Methods: we evaluated patients for the signs and symptoms of candidosis before receiving the study drug and on days 4, 7 and 14. We assessed patients who were cured or improved after 7‐14 days of treatment 2 weeks after the end of treatment (follow-up). We obtained specimens from buccal lesions for microscopic examination (baseline only) and culture at baseline and on days 7 and 14. Patients were evaluated for adverse events on days 4, 7 and 14. Results: one hundred and fifty patients received fluconazole and 155 received amphotericin B. There were no statistically significant differences in clinical or mycological response between fluconazole and amphotericin B at the end of treatment or at follow-up. At the end of treatment, 122 (81%) of 150 fluconazole-treated and 135 (87%) of 155 amphotericin B-treated patients were clinically cured or improved. Mycological cure rates were 35% and 46% for fluconazole and amphotericin B, respectively. The symptoms of burning sensation and buccal pain resolved significantly sooner (P < 0.05) in fluconazole-treated patients. The presence of dentures did not affect the response to antifungal therapy. The incidence of adverse events was 46% in the fluconazole group and 50% in the amphotericin B group (not statistically significant). Conclusion: fluconazole oral suspension is a good therapeutic alternative to amphotericin B oral suspension in the treatment of older patients with oropharyngeal candidosis. |
| Databáze: | OpenAIRE |
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