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Journal of Antimicrobial Chemotherapy (1996) 37, 275-283
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

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

Jonathan D. Cartledge, Jenifer Midgley and Brain G. Gazzard*

Department of HIV/Genito-urinary Medicine, Chelsea & Westminster Health Care Trust 369 Fulham Road, London SWW9NH, UK

Received 2 December 1994; returned 12 February 1995; accepted 15 September 1995

*Corresponding author Tel: +44-(0)181-746-8239; Fax: +44-(0)181-746-561 I

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 (10–5M) fluconazole relative to growth in drug free medium. Using a receiver operator characteristic curve, a relative growth in fluconazole of ≥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.


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