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July 1971

Prolonged Oral Treatment of Chronic Mucocutaneous Candidiasis With Amphotericin B

Author Affiliations

Birmingham, Ala; Columbus, Ga

From the departments of dermatology (Drs. Montes, Bradford and Lauderdale), microbiology (Drs. Montes and Cooper), and pediatrics (Dr. Cooper), University of Alabama in Birmingham Medical Center. Dr. Taylor is in private practice in Columbus, Ga.

Arch Dermatol. 1971;104(1):45-56. doi:10.1001/archderm.1971.04000190047007

Amphotericin B was given orally to four patients with chronic mucocutaneous candidiasis (CMCC) using a total daily dose of 1,000 to 1,800 mg. In one patient continuous treatment over a six-month period resulted in complete clearing of extensive candidal granuloma lesions. In another candidal granuloma patient a slower but continuous excellent response occurred. A hypothyroid patient and a patient with associated thymoma-myositis failed to respond. Higher antibiotic serum levels in the first two patients indicate significant individual variations in absorption may exist and probably account for the different results. The intracellular location of Candida albicans observed with the electron microscope suggests tissue levels were also, and perhaps more directly, involved in the therapeutic response. In view of this experience, and the lack of a nontoxic effective treatment, a more extensive oral trial of amphotericin B in CMCC seems fully justified.