Use of Sargramostim (rh-GM-CSF) as adjunctive treatment of fluconazole-refractory oropharyngeal candidiasis in patients with AIDS: A pilot study

Jose A. Vazquez, Jose A. Hidalgo, B. S.N. Sharon De Bono

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Fluconazole-refractory mucosal candidiasis is a significant problem in patients with advanced HIV disease. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is postulated to activate neutrophils, enhance phagocytosis, and increase intracellular killing of Candida species. The aim of this study was to evaluate the use of sargramostim (rh-GM-CSF) in combination with fluconazole for refractory mucosal candidiasis in patients with AIDS. Method: Patients with mycologically confirmed fluconazole-refractory oropharyngeal candidiasis who failed fluconazole 400 mg/day for a minimum of 7 days were enrolled, continued on fluconazole (400 mg/day), and received sargramostim 2.5 μg/kg/day for a minimum of 2 weeks. Patients were evaluated for clinical signs and symptoms of oropharyngeal candidiasis, and quantitative fungal cultures were taken at baseline and the end of weeks 1 and 2 of therapy. Results: Eleven patients were entered, 3 out of 11 patients were cured, 6 were unchanged, and 2 were worse at the 2-week evaluation. Mycological response was seen in 7 out of 11 patients. Conclusion: In this small pilot study, sargramostim appears to exert a beneficial effect on the mucosal mycoflora and may be a possible alternative as adjunctive therapy in the management of fluconazole-refractory mucosal candidiasis in advanced HIV-positive patients.

Original languageEnglish (US)
Pages (from-to)23-29
Number of pages7
JournalHIV Clinical Trials
Volume1
Issue number3
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

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Keywords

  • GM-CSF
  • HIV
  • Oral candidiasis

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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