The Susceptibility Study of Fluconazole to Candida Species in Patients with Onychomycosis

Hahn, Hyung Jin; Kim, Sang Min; Lee, Yang Won; Choe, Yong Beom; Ahn, Kyu Joong

Abstract

BACKGROUND
With a growing number of people using a variety of medications, and suffering from systemic diseases, such as AIDS, Candida infection is also on the rise. This brings the issue of antifungal resistance into the spotlight.
OBJECTIVE
This study sought to evaluate the detection of oral Candida and the change of minimum inhibitory concentration (MIC) in patients on oral fluconazole for treatment of onychomycosis.
METHODS
We studied 25 patients who are on fluconazole for treatment of onychomycosis. We evaluated the MIC and detection of oral Candida at the time of the first visit, at the point of initial dosing, and subsequently, 12 and 24 weeks thereafter, and 12 weeks after the point of final dosing.
RESULTS
At the first visit, we collected strains from the oral cavity. At 12 and 24 weeks thereafter, and 12 weeks after final dosing, C. albicans were detected in all cases. MIC measured at the corresponding time points revealed sensitivity in all cases with MIC under 8.0 microg/ml. After 12 and 24 weeks of administration, we identified the same strains at the oral cavity, and MIC of the two regions was elevated. At 12 weeks after the point of final dosing, MIC was decreased or remained the same at the three sites, and the result was the same at 12 and 24 weeks thereafter.
CONCLUSION
The purpose of this study was to ascertain that the acquisition of resistance to fluconazole by oral Canadida is not as serious as we had anticipated; however, further studies based on larger patient pools would provide greater assurance.