Gil A, Lavilla P, López Dupla M, Valencia E, Pintado V, Khamashta M, García Puig J, Ortiz-Vázquez J
Servicio de Medicina Interna, Hospital La Paz, Universidad Autónoma, Madrid.
Med Clin (Barc). 1992 Apr 25;98(16):612-7.
To evaluate the efficacy and pharmacological safety of 2 therapeutic trials with fluconazole in candida esophagitis in AIDS patients.
A total of 75 episodes of candida esophagitis in 70 AIDS patients were included in an open prospective study. In group I 36 patients were included who received 200 mg of fluconazole orally the first day followed by 100 mg daily for 4 weeks. In group II (34 patients) the length of treatment was reduced to 10 days with the same daily doses. Therapeutic response was evaluated by esophagoscopy, biopsy and fungal culture.
The protocol was completed at 68 episodes with a cure being obtained in all but 2 patients in group II. No significant differences in clinical response were found between the 2 groups. The incidence of oropharyngeal colonization at the end of treatment was greater in patients from group I than from group II (43% vs 11%). Fluconazole was well tolerated in all the patients. A slight alteration of the hepatic enzymes was observed in 29 cases (40%) with a lower incidence in the shorter time group (p less than 0.001), however, treatment was discontinued only in 1 patient because of severe asymptomatic hepatic dysfunction to which a relation with the drug is unclear.
Fluconazole in an efficient and safe agent in the treatment of candida esophagitis in AIDS patients. A 10 day treatment is a useful as longer treatment and has a lower risk of adverse effects.
评估两项使用氟康唑治疗艾滋病患者念珠菌性食管炎的疗效及药物安全性。
一项开放性前瞻性研究纳入了70例艾滋病患者共75次念珠菌性食管炎发作。第一组纳入36例患者，首日口服氟康唑200mg，之后每日100mg，共4周。第二组（34例患者）使用相同日剂量，但治疗时长减至10天。通过食管镜检查、活检及真菌培养评估治疗反应。
68次发作完成了方案治疗，除第二组2例患者外均获治愈。两组间临床反应无显著差异。治疗结束时，第一组患者口咽定植发生率高于第二组（43%对11%）。所有患者对氟康唑耐受性良好。29例（40%）出现肝酶轻度改变，短疗程组发生率较低（p<0.001），然而，仅1例患者因严重无症状肝功能障碍（与药物关系不明）而停药。
氟康唑是治疗艾滋病患者念珠菌性食管炎的有效且安全的药物。10天疗程与更长疗程同样有效，且不良反应风险更低。
