- The severity of infection depends on the degree of the patient's immunosuppression.
- Candidiasis is common in the HIV-infected host.
- Location of infection can be oral, esophageal, or vaginal.
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- Oral and vaginal candidiasis usually responds to local therapy with troches or creams (nystatin or clotrimazole).
- For patients who do not respond or who have esophageal candidiasis, fluconazole, 100â??200 mg PO daily, is the treatment of choice.
- Fluconazole-resistant candidiasis is becoming increasingly frequent, especially in patients with advanced disease who have been receiving antifungal agents for prolonged periods.
- Itraconazole oral suspension (200 mg bid) is occasionally effective. Many patients require amphotericin B, either as an oral suspension (100 mg/mL swish and swallow qid) or parenterally.
- Caspofungin, an echinocandin, can be considered for refractory cases using an induction dose of 70 mg IV the first day and then 50 mg IV daily for maintenance.
- Voriconazole may also be useful.