A single 750 milligram dose of Diflucan (fluconazole) is as safe and effective as taking 150 mg of Diflucan once daily for 14 days in curing oral candidiasis, also known as thrush, according to a study in the October 7 issue of Clinical Infectious Diseases.

Oral candidiasis is a common infection in people living with HIV, particularly those with low CD4 counts. A single-dose therapy potentially increases convenience and lowers the cost of treatment. Several previous studies have found that a single dose of Diflucan at 150 mg was at least partially effective in curing oral candidiasis without relapse. These studies, however, were small and found higher relapse rates compared with standard 14-day dosing.

To determine the efficacy of higher dose Diflucan taken only once, Omar Hamza, MD, of the Muhimbili University of Health and Allied Sciences in Dar Es Salaam, Tanzania, and his colleagues enrolled 220 HIV-positive patients with oral candidiasis. Half received a single dose of 750 mg Diflucan and the other half received 150 mg Diflucan, taken once daily for 14 days.

The clinical cure rates of the two strategies, determined by the resolution of symptoms, were nearly identical at roughly 95 percent. Lab tests taken from scrapings of the tongue revealed that 84 percent of the single-dose treatment group had total clearance of the candida fungus, while 75 percent of the 14-day treatment group had clearance of the fungus. The rate of side effects, which typically involved mild stomach upset, was very low in both groups. The authors, therefore, conclude that single-dose 750 mg Diflucan treatment may be safely used in HIV-positive people diagnosed with oral candidiasis. These results do not, however, apply to vaginal candidiasis or candidiasis that is more widespread throughout the body.