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Thrush treatment and antibiotics
Jan 25, 2001

Dr, I have just tested HIV+ and also found out I have "full-blown AIDS" Viral load 236,000 and CD4 count of 130. I have no symptoms with the exception of what my doctor has diagnosed as THRUSH. The back 2/3 of my tongue is completely covered in a whitish to yellowish almost fuzzy looking substance. No pain or discomfort. I have been taking Mycelex for 4 days with no improvement. After talking to my doctor on the phone he suggested switching me to dfloxin. After doing some research on THEBODY.com it occurs to me that I have just finished a Flagel treatment for Giardia. Could this be causing this?? If so, should I start the Difloxin right away or wait to see what happens? I just decided to eat yogurt!! thanks

Response from Dr. Reznik

A white to yellowish coating on the back 2/3 of the tongue, does not necessarily mean you have thrush (candidiasis). Just because you have AIDS and have recently been on an antibiotic does not necessarily mean that you have candidiasis. If there are no other suspicious areas in your mouth, chances are you have a case of coated tongue which does not respond to antifungal therapy. This may explain why a few days of Mycelex troches did not work. The recommended treatment time for candidiasis, whether you are using topical or systemic medications, is two full weeks. My first recommendation would be to finish the course of the topical preparation, as Mycelex troches are very effective in managing mild to moderate oral candidiasis. I would recommend against beginning a course of Diflucan, unless someone experienced in the oral manifestations of HIV/AIDS has performed an examination and suggested this course of therapy. Diflucan (fluconazole) is the most effective systemic medication used in the management of moderate to severe oropharyngeal candidiasis, but recent published reports consistently mention an increase in the incidence of resistance to this drug. By limiting your exposure to a systemic agent, you decrease the possibility of developing resistance.

Take care and feel better soon!

DR


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