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Resistance to flucanozole
Feb 24, 2001

Last year, I struggled constantly with thrush. I became resistant to flucanozole, so my doctor put me on amphotericin B. I responded well to that, re-started treatment with sustiva and combivir, and did very well virologically. However, due to some body shape changes and weight gain, I decided to stop the antiviral therapy. The thrush is starting to return, albeit very mildly so far. My doctor suggests restarting flucanozole every other day. My question is this: is it once resistant always resistant? or is there hope that it will work anew?

Response from Dr. Feinberg

I think your thrush is not very likely to respond to fluconazole if resistance has been demonstrated already. And even if you were lucky enough to develop sensitive thrush after having had resistance, treating it every other day would only encourage resistance. A better choice would be to try fluconazole (or itraconazole) for a steady 5-10 course and see what happens. A best choice would be to go back on anti-HIV therapy, so you can give your immune system a boost, but only you can decide if body shape change is better or worse than being sick. Good luck!

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