Itraconazole and fluconazole in oropharyngeal candidiasis
Infections of the oral cavity with Candida species occur commonly, and in most cases treatment is fairly simple. In an attempt to produce antifungal agents with a lower toxicity and better pharmacokinetics profile than ketoconazole, a new group of antimycotics, the triazoles, has been developed. Reported animal and human studies suggest that itraconazole and fluconazole are promising new fungal agents for treating oropharyngeal candidiasis. Both have been found to be effective in the treatment of chronic oral candidiasis and candidiasis associated with HIV infection. The exact mechanism of action of fluconazole is not known, but candidal adhesion to buccal epithelial cells is significantly reduced by the intake of this antifungal, and the effect persists for at least a week after therapy stops. The authors conclude that more clinical trials and comparisons with antifungal agents currently in vogue need to be carried out to determine whether their initial promise will be fulfilled. [M.O.]
van der Bijl, P., and T.M. Arendorf, Ann Dent, 52:12, 1995