Candidiasis antifungal resistant

Flucytosine is an oral antifungal pro-drug. It has to be enzymatically deaminated by the fungi to the active metabolite, fluorouracil. Fluorouracil inhibits thymidylate synthetase and DNA synthesis. Its indications are treatment of cryptococcal meningitis and serious systemic candidiasis. Resistance develops rapidly, due to altered drug-permeability. For this reason Amphotericin B and flucytosine are often given in combination as they have synergistic effects. 

Oral candidiasis - besides other predisposing factors - is a common disease in the immunocompromised patient and should remind clinicians of the possibility of HIV infection. It is often associated with esophageal manifestations. Relapsing or chronic persistent vulvovaginal candidiasis has been reported in up to 50% of HIV-infected women, therefore some authors recommend HIV testing in this condition too [58]. Resistance to antifungal drugs is a common problem... 

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