Treatment of azole-resistant oropharyngeal candidiasis with topical amphotericin B

Shellee A. Grim, Kelly M. Smith, Frank Romanelli, Ighovwerha Ofotokun, Annette Pérez, Jean Marie Kaiser

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


OBJECTIVE: To report a case of successful treatment of azole-refractory oropharyngeal candidiasis with topical amphotericin B. CASE SUMMARY: A 30-year-old white woman presented with recurrent oral thrush. The patient had been exposed to azole antifungals for >20 years, and in vitro susceptibility tests revealed class resistance. The patient started taking amphotericin B 100 mg oral suspension swish-and-spit 4 times daily. After 4 weeks of topical amphotericin B treatment, the patient reported significant symptomatic improvement. The oral candidiasis worsened following a course of oral antibiotics, but improved once the antibiotic was discontinued and after receiving amphotericin B swish-and-swallow for 4 additional weeks. DISCUSSION: Current Infectious Diseases Society of America guidelines include topical amphotericin B as a potentially effective option for the treatment of oropharyngeal candidiasis. There is limited evidence to support this recommendation. Besides lack of data, an appropriate dosing regimen and consistent means of product formulation need to be determined. CONCLUSIONS: This report demonstrates the potential role for topical amphotericin B in the treatment of azole-refractory oral candidiasis. Double-blind, randomized, controlled trials are needed to define dosing, efficacy, administration, and long-term safety of oral amphotericin B.

Original languageEnglish
Pages (from-to)1383-1386
Number of pages4
JournalAnnals of Pharmacotherapy
Issue number9
StatePublished - Sep 2002


  • Amphotericin B
  • Azole resistant
  • Oropharyngeal candidiasis

ASJC Scopus subject areas

  • Pharmacology (medical)


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