Efficacy of Melaleuca Oral Solution for the Treatment of Fluconazole Refractory Oral Candidiasis in AIDS Patients

AIDS. 1998 Jun 18;12(9):1033-7.

Abstract

Objective: To evaluate the efficacy of melaleuca oral solution in AIDS patients with fluconazole-resistant oropharyngeal candida infections.

Design: A prospective, single center, open-labeled study.

Setting: A university-based inner-city HIV/AIDS clinic.

Patients: Thirteen patients with AIDS and oral candidiasis documented to be clinically refractory to fluconazole, as defined by failure to respond to a minimum of 14 days of > or = 400 mg fluconazole per day. Additionally, patients had in vitro resistance to fluconazole, defined by minimal inhibitory concentrations of > or = 20 microg/ml.

Interventions: Patients were given 15 ml melaleuca oral solution four times daily to swish and expel for 2-4 weeks.

Main outcome measures: Resolution of clinical lesions of oral pseudomembranous candidiasis lesions. Evaluations were performed weekly for 4 weeks and at the end of therapy for clinical signs of oral candidiasis. Quantitative yeast cultures were performed at each evaluation.

Results: A total of 13 patients were entered into the study, 12 were evaluable. At the 2-week evaluation, seven out of 12 patients had improved, none were cured, and six were unchanged. At the 4-week evaluation, eight out of 12 patients showed a response (two cured, six improved), four were non-responders, and one had deteriorated. A mycological response was seen in seven out of 12 patients. A follow-up evaluation 2-4 weeks after therapy was discontinued revealed that there were no clinical relapses in the two patients who were cured.

Conclusions: Melaleuca oral solution appears to be effective as an alternative regimen for AIDS patients with oropharyngeal candidiasis refractory to fluconazole.

Publication types

  • Clinical Trial

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / microbiology
  • Adult
  • Antifungal Agents / therapeutic use*
  • Candidiasis, Oral / drug therapy*
  • Candidiasis, Oral / microbiology
  • Drug Resistance, Microbial
  • Female
  • Fluconazole / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Mouthwashes / therapeutic use*
  • Prospective Studies
  • Tea*
  • Treatment Failure
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Mouthwashes
  • Tea
  • Fluconazole