HIV: Opportunistic infections, treatment of candidiasis

on 30.9.09 with 1 comment



Candida albicans

in the mouth, throat and oesophagus causes difficulty in swallowing. This fungal infection can be treated with gentian violet or nystatin tablets, ketoconazole (Nizoral®), topical miconazole (Daktarin®), systemic itraconazole (Sporanox®) or fluconazole (Diflucan®). Gentian violet (1.5 ml 0.5 % aqueous solution, 2 x per day) is cheap, but stains the mouth purple. Gentian violet does not help in oesophageal candidiasis. Itraconazole and fluconazole are very expensive. Buccal tablets containing miconazole in a prolonged release formulation can be placed under the upper lip for local (topical) treatment of oropharyngeal candidiasis. Voriconazole, a new triazole, is very promising but at the moment there is very little data on it. It is also active against Candida kruseii, a yeast that is inherently resistant to fluconazole. It penetrates the blood-brain barrier and can be used in cases resistant to amphotericin B. Caspofungin (Cancidas®) belongs to the new class of echinocandins, and is active against divers Candida species (C. albicans and several C. non-albicans, including C. krusei). The normal dose is 70 mg as a single start-dose, followed by 50 mg/day IV. For patients heavier than 80 kg, a daily dose of 70 mg/day is advised. In case of medium liver failure (Child-Pughscore 7-9) 35 mg/day as maintenance dose is advised. There is no need for dose-adjustment in case of renal failure.

Category: Medical Subject Notes , Medicine Notes , Pharmacology Notes

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April 4, 2013 at 4:27 PM

AIDS certainly comes to mind whenever STDs are discussed. Acquired immunodeficiency syndrome is a sexually transmitted disease affecting tens of millions worldwide. It is caused by human immunodeficiency virus (HIV), which targets the immune system primarily the CD4+ T cells. HIV can be transmitted through sexual fluids, blood or breast milk.

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