Thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. Randomized, double-blind, placebo-controlled study of 100-mg oral fluconazole daily.
Thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. Randomized, double-blind, placebo-controlled study of 100-mg oral fluconazole daily.
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患有获得性免疫缺陷综合症和获得性免疫缺陷综合症相关综合症的患者可以预防鹅口疮。
DOI：
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发表时间：
1991
影响因子：
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通讯作者：
O. S. Lang
中科院分区：
文献类型：
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作者：
D. Stevens;S. Greene;O. S. Lang
复发性口咽念珠菌病在患有获得性免疫缺陷综合征和获得性免疫缺陷综合征相关复合体的患者中很常见。它会导致局部疼痛和不适、味觉丧失和对食物的厌恶，并可能导致继发性并发症。在一项双盲研究中，我们检查了预防措施是否可以预防复发的鹅口疮。25名有一到四次鹅口疮发作的患者在研究开始时没有鹅口疮，他们被随机分成两组，每天服用100毫克氟康唑或安慰剂，持续12周。如果出现鹅口疮，则停止预防，并对患者进行常规治疗，之后恢复预防。随机研究后，部分患者接受持续氟康唑(开放阶段)治疗。在这项随机研究中，13名服用安慰剂的患者中有8名患者出现了鹅口疮，12名接受氟康唑治疗的患者中没有一名患者出现鹅口疮。两组之间可能的副作用没有差异。在接受氟康唑治疗的患者中，皮肤真菌病、甲真菌病和隐球菌病也得到改善，真菌定植显著减少。1名间歇性顺应性患者(总计71.5名患者--接受氟康唑治疗数月)在开放时出现鹅口疮；相比之下，这25名患者在入院前也有两次念珠菌食管炎，三次隐球菌病和13次皮肤真菌病。在进入随机试验后，在92.3个月的无氟康唑患者中，有35次鹅口疮，1次食管炎，1次隐球菌血症和1次皮肤真菌病，原有的皮肤真菌病和甲真菌病没有变化或恶化。接受氟康唑治疗和不接受氟康唑治疗的个别患者也显示了其疗效。总之，在获得性免疫缺陷综合征和获得性免疫缺陷综合征相关复合体的患者中，鹅口疮是可以预防的，毒性效应可以忽略不计。应该考虑进行更大规模的试验，以确认预防所有真菌病的预防措施。
Recurrent oropharyngeal candidiasis is common in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. It causes local pain and discomfort, loss of taste, and aversion to food and may lead to secondary complications. We examined, in a double-blind study, whether recurrent thrush could be prevented by prophylaxis. Twenty-five patients with one to four previous thrush episodes who had no thrush at the outset of the study were randomized to receive 100 mg of fluconazole or placebo daily for 12 weeks. If thrush occurred, prophylaxis was stopped and patients were treated conventionally, after which prophylaxis was resumed. After the randomized study, some patients were given continuous fluconazole (open phase). In the randomized study, thrush occurred in eight of 13 placebo-treated patients and none of 12 fluconazole-treated patients. Possible side effects were not different between the groups. Dermatophytosis and onychomycosis and cryptococcuria also improved in the fluconazole-treated patients, and fungal colonization was significantly decreased. One episode of thrush occurred in the open phase in an intermittently compliant patient (group total, 71.5 patient-months of fluconazole treatment); in contrast, the 25 patients also had had two episodes of Candida esophagitis, three of cryptococcosis, and 13 of dermatophytosis before entry. Subsequent to entry in the randomized trial, in 92.3 patient-months without fluconazole, there were 35 episodes of thrush, one of esophagitis, one of cryptococcemia, and one of dermatophytosis, and preexisting dermatophytosis and onychomycosis were unchanged or worsened. Individual patients observed with and without fluconazole treatment also showed its efficacy. In conclusion, thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex with negligible toxic effects. Larger trials to confirm prevention of all mycoses with prophylaxis should be considered.