{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T19:07:52Z","timestamp":1771355272847,"version":"3.50.1"},"reference-count":7,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1997,6]]},"abstract":"<jats:p>AIMS: To compare the serum concentrations of itraconazole and hydroxyitraconazole after treatment with itraconazole cyclodextrin solution and itraconazole capsules in human immunodeficiency virus (HIV) positive patients with oral candidosis. METHODS: The pharmacokinetics of itraconazole and its active metabolite hydroxy-itraconazole were assessed on days 1 and 7 of therapy in acquired immunodeficiency syndrome (AIDS) patients with oral candidosis taking either itraconazole solution or capsules and the serum concentrations (measured by high performance liquid chromatography) correlated with the clinical response to therapy. In addition, the in vitro susceptibility of Candida spp isolates taken from patients at the start of the therapy was assessed. RESULTS: Nine of 16 patients treated with itraconazole capsules and eight of 15 treated with the solution responded to treatment. Three of the non-responders in each treatment group were infected with isolates resistant to itraconazole in vitro. Although with both preparations there was considerable inter-patient variability in the maximum recorded serum concentrations of itraconazole, they were significantly lower on day 1 and day 7 in those receiving capsules compared with those taking the solution. Patients unresponsive to therapy, but infected with susceptible isolates, had significantly lower concentrations of itraconazole and hydroxyitraconazole levels on days 1 and 7 than patients responding to treatment. However, patients infected with itraconazole resistant isolates (tested in vitro) failed to respond to treatment despite achieving similar serum concentrations of itraconazole and hydroxy-itraconazole to the responsive patients. For patients with in vitro susceptible isolates a serum itraconazole concentration of &lt; 1000 ng\/ml on day 7 was predictive of therapeutic failure (specificity 71%, sensitivity 100%). CONCLUSIONS: Itraconazole cyclodextrin solution achieves higher serum itraconazole and hydroxy-itraconazole concentrations than the capsule formulation in AIDS patients, and this is associated with improved efficacy.<\/jats:p>","DOI":"10.1136\/jcp.50.6.477","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"477-480","source":"Crossref","is-referenced-by-count":103,"title":["Itraconazole solution: higher serum drug concentrations and better clinical response rates than the capsule formulation in acquired immunodeficiency syndrome patients with candidosis."],"prefix":"10.1136","volume":"50","author":[{"given":"J D","family":"Cartledge","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Midgely","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B G","family":"Gazzard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.7326\/0003-4819-109-6-471","article-title":"Gastropathy and ketoconazole malabsorption in the acquired immunodeficiency syndrome (AIDS)","volume":"109","author":"Lake-Bakaar, G.; Winston, T.; Lake-Bakaar, D.; Gupta, N.; Beidas, S.; Elsakr, M.","year":"1988","unstructured":"Lake-Bakaar G, Winston T, Lake-Bakaar D, Gupta N, Beidas S, Elsakr M, et al. Gastropathy and ketoconazole malabsorption in the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1988;109:471-3.","journal-title":"Ann Intern Med"},{"key":"ref_2","first-page":"105","article-title":"The effects of H2-receptor antagonists on the pharmacokinetics of itraconazole, new oral antifungal","volume":"27","author":"Stein, A.; Daneshmend, T.K.; Warnock, D.W.; Bhaskar, N.; Burke, J.; Hawkey, C.J.","year":"1987","unstructured":"Stein A, Daneshmend TK, Warnock DW, Bhaskar N, Burke J, Hawkey CJ. The effects of H2-receptor antagonists on the pharmacokinetics of itraconazole, new oral antifungal. BrJ Clin Pharmacol 1987;27:105-6.","journal-title":"BrJ Clin Pharmacol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/jac\/33.5.1071","article-title":"Itraconazole cyclodextrin solution; effective treatment for HIVrelated candidosis unresponsive to other azole therapy","volume":"33","author":"Cartledge, J.D.; Midgley, J.; Youle, M.; Gazzard, B.G.","year":"1994","unstructured":"Cartledge JD, Midgley J, Youle M, Gazzard BG. Itraconazole cyclodextrin solution; effective treatment for HIVrelated candidosis unresponsive to other azole therapy. J. Antimicrob Chemother 1994;33:1071-3.","journal-title":"J. Antimicrob Chemother"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/00002030-199702000-00005","article-title":"Itraconazole cycladextrin solution. Oral and in vitro susceptability testing in predicting successful treatment of HIV related fluconazole resistant and fluconazole susceptible oral candidosis","volume":"11","author":"Cartledge, J.D.; Midgely, J.; Gazzard, B.G.","year":"1997","unstructured":"Cartledge JD, Midgely J, Gazzard BG. Itraconazole cycladextrin solution. Oral and in vitro susceptability testing in predicting successful treatment of HIV related fluconazole resistant and fluconazole susceptible oral candidosis. AIDS 1997;11: 163-9.","journal-title":"AIDS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/jac\/21.1.93","article-title":"Comparison of high performance liquid chromatographic and microbiological methods of determination of itraconazole","volume":"21","author":"Warnock, D.W.; Turner, A.; Burke, J.","year":"1988","unstructured":"Warnock DW, Turner A, Burke J. Comparison of high performance liquid chromatographic and microbiological methods of determination of itraconazole. J Antimicrob Chemother 1988;21:93-100.","journal-title":"J Antimicrob Chemother"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1128\/AAC.36.8.1727","article-title":"Antifungal susceptibility testing of Candida species by relative growth measurement at single concentrations of antifungal agents","volume":"36","author":"Odds, F.C.","year":"1992","unstructured":"Odds FC. Antifungal susceptibility testing of Candida species by relative growth measurement at single concentrations of antifungal agents. Antimicrob Agents Chemother 1992;36:1727-37.","journal-title":"Antimicrob Agents Chemother"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1128\/AAC.32.9.1310","article-title":"Pharmacokinetics of itraconazole following oral administration to normal volunteers","volume":"32","author":"Hardin, T.C.; Graybill, JR, Fetchick; R, Woestenorghs; R, Rinaldi; MG, Kuhn; J.G.","year":"1988","unstructured":"Hardin TC, Graybill JR, Fetchick R, Woestenorghs R, Rinaldi MG, Kuhn JG. Pharmacokinetics of itraconazole following oral administration to normal volunteers. Antimicrob Agents Chemother 1988;32:1310-13.","journal-title":"Antimicrob Agents Chemother"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.50.6.477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T05:59:04Z","timestamp":1765691944000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.50.6.477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1997,6,1]]},"published-print":{"date-parts":[[1997,6]]}},"alternative-id":["10.1136\/jcp.50.6.477"],"URL":"https:\/\/doi.org\/10.1136\/jcp.50.6.477","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,6]]}}}