Fluconazole Resistant Oral Candidiasis on HIV Patient - What Other Drug can We Choose? A Case Report

The majority of HIV / AIDS patients have common secondary infections including of oral candidiasis. Fluconazole can be used to treat oral resistance in candidiasis. Management that can reduce risk can be minimized. However, some evidences suggest that the use of fluconazole is not effective for oral candidiasis. A 34-year-old male patient went to Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, with main complaint of discomfort and pain in the tongue. The physical examination showed a white pseudomembrane on the tongue and palate, which could be removed but left reddish and painful marks. The examination from tongue and palate swab found a colony of white Candida albicans and showed resistant to fluconazole, intermediate to ketoconazole, and sensitive to nystatin. The patient received nystatin oral suspension for three times a day as much as 5 ml (500,000 units). The pseudomembrane disappeared on day 10. The medication continued for fourteen days. No sign of recurrent found in two weeks after the treatment. The administration of nystatin can be used as an effective medication for oral candidiasis.