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Serum Itraconazole Concentrations And Clinical
Responses In Candida-associated Denture
Stomatitis Patients Treated With Itraconazole
Solution And Itraconazole Capsules
RR PUTRI AYU HAPSARI
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Abstract
The aim of this study was to compare the concentrations
of itraconazole in serum and saliva after treatment with
itraconazole cyclodextrin solution or itraconazole
capsulesin Candida-associated denture stomatitis
patients without evidence of immunodeficiency
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40 patient were randomly itraconazole
cyclodextrin solution or itraconazole capsules
100 mg for 15 days On completion of treatment
Serum and saliva samples
itraconazole concentrations measured
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Introduction
Candida-associated denture stomatitis is
characterized by chronic erythema and oedema
of the palatal mucosa beneath an upper denture
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Patients And Methods
Age Range 29-81
Mean 62 years
9 Male31 Female
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clinical evidence of denture stoma-titis and positive yeast cultures from both the palatal
mucosa and dorsum of the tongue
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Include:
All were edentulous denture wearers with clinical
evidence of denture stoma-titis and positive yeast
cultures from both the palatal mucosa and dorsum of the
tongue
Exclude:
Pregnant, lactating or of child-bearing age and not using
reliable contraception; had impaired renal or hepaticfunction; had used an antifungal agent within the
preceding 10 days
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The 40 patients were
randomized
cyclodextrin
solution of
itraconazole
itraconazole
capsules
at a dose
of 100 mg15
days
at a dose
of 100 mg
15
days
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itraconazole
solutionitraconazole
capsules after
food
1 h
before
food
All patients
werereviewed
after 15
days
anerythema
meter
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1 mL of
whole
saliva
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VS
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ResultsCyclodextrin group (n= 18)
Capsule group (n= 18)
serum(mg/L)
saliva(mg/L)
time (h)since lastdose
serum(mg/L)
saliva(mg/L)
time (h)since lastdose
1.08 0.16 8.25 0.37 0.00 21
0.75 0.00 19 0.83 0.00 2
0.00 0.00 5.75 1.42 0.00 2.5
1.20 0.00 4 0.87 0.00 2
0.56 0.68 3.5 0.45 0.00 2.25
1.03 0.48 2 1.23 0.00 4.5
0.34 0.00 4.25 0.31 0.00 20
1.03 1.50 7.5 0.93 0.00 1.25
0.68 0.17 2 0.71 0.00 3
1.26 0.07 2 0.21 0.00 5
1.17 0.69 6.5 0.91 0.00 2
0.28 1.04 3 1.24 0.00 28.5
0.00 0.21 5 0.50 0.00 1.25
0.68 0.00 6.5 0.51 1.68 1.75
1.50 0.05 3 0.39 7.40 5
0.73 0.06 3.5 0.34 0.00 1.75
1.48 0.53 2.25 0.39 0.00 3.25
0.50
0.02
2.5
1.09
0.02
4.25
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C. albicans
Of the 40 study participants, 18 were infected with more
than one species of yeast
C. glabrata
was found in 12 patients at baseline and persisted post-
treatment in all
Candida tropicalis, Candida krusei, Candidaparapsilosis, Candida guillermondiiand Saccharomyces
cerevisiaewere present in samples from only a few of
the patients at baseline
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Discussion
1. Itraconazole Capsules
gastric acidity, the bioavailability of the itraconazole
being reduced in the fasting state or under
conditions of hypochlorhydria
2. Cyclodextrin Solution of Itraconazole
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-----------------
Nevertheless, it is interesting to note that
the majority of mycologically cured patients in this
clinical trial had serum itraconazole concentrationsof greater than 0.6 mg/L
whereas most of the mycologically non-cured
patientshad serum itraconazole concentrations of
0.5 mg/L or less
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concentrations of itraconazole in their saliva
(P< 0.001)
cyclodextrin group >itraconazole capsule group
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There was no relationship between the serum
and saliva itraconazole concentrations of the
group on the cyclodextrin preparation
(P= 0.704)
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CONCLUSIONS
The absorption of itraconazole with the liquid
preparation was no greater than with the
capsules, but itraconazole was more likely to be
found in the saliva on treatment with the liquidpreparation. Itraconazole cyclodextrin solution
and itraconazole capsules were equally effective
in the treatment of denture stomatitis
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REFERENCES
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THANK YOU
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