Ketoconazole: A Re-emerging choice for Oral candidiasis in patients with human immunodeficiency virus infection/acquired Immunodeficiency Syndrome

Abstract

Background: The long term use of antifungals for oral candidiasis (OC) in patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) causes some strains to be resistant to certain antifungals. HIV/AIDS are currently most common in men. Aim: To evaluate ketoconazole sensitivity on Candida species in male HIV/AIDS patients with OC. Method: This is an observational descriptive study at the Outpatient Unit and Inpatient Installation of the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo, Surabaya. Samples were taken from HIV/AIDS male patients with OC using sterile swabs. The smear was cultured in CHROMagar Candida incubated at 37°C for 48-72 hours, and Sabouraud Dextrose Agar media for 48 hours at 28°C. Species identification were done using carbohydrate and Cornmeal test. Resistance test was done by disk diffusion method. Results: There were 23 research subjects with 40 isolates of Candida species growing in culture. The most common species was C. albicans in 23(57.5%) isolates, while Candida non-albicans were found in 17(42.5%) isolates. The sensitivity test results showed that 34 (85%) isolates were sensitive, while 2(5%) isolates were resistant to ketoconazole. All C. albicans (23 [100%]) and most Candida non-albicans species (11 [64%]) were sensitive to ketoconazole. Conclusion: Ketoconazole can be recommended as a treatment option for OC patients with HIV/AIDS due to the high sensitivity of both C. albicans and non-albicans to this drug.