Fluconazole-refractory oropharyngeal candidiasis

Fluconazole-refractory oropharyngeal candidiasis is a common condition in human immunode-ciency virus (HIV) -positive patients. Twelve such patients were treated with 15 mL of a M. alterni-folia oral solution (Breath-Away) four times daily for 2 weeks, in a single center, open-label clinical trial. The solution was swished in the mouth for 30-60 s and then expelled, with no rinsing for at least 30 min. Clinical assessment was carried out on days 7 and 14, and also on days 28 and 42 of the follow-up. Two patients were clinically cured and six were improved after the therapy however, four remained unchanged and one deteriorated. The overall clinical response rate was thus 67% and was considered as a possible alternative antifungal treatment in such cases (Jandourek et al., 1998). 

Oropharyngeal candidiasis - 200 mg/day for 1 to 2 weeks. Vigorously swish the solution in the mouth (10 ml at a time) for several seconds and swallow. For patients with oropharyngeal candidiasis unresponsive/refractory to treatment with fluconazole tablets, the recommended dose of itraconazole is 100 mg twice daily. Expect clinical response in 2 to 4 weeks. Patients may be expected to relapse shortly after discontinuing therapy. Limited data on the safety of long-term use (more than 6 months) of the oral solution are available at this time. 

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