For esophageal candidiasis, which medication is typically used?

Esophageal candidiasis is an infection of the esophagus caused by the Candida species, most commonly Candida albicans. The preferred treatment for this condition is fluconazole, an antifungal agent that belongs to the azole class of drugs. It works by inhibiting fungal cytochrome P450 enzymes, which are involved in the synthesis of ergosterol, a critical component of the fungal cell membrane. By disrupting the production of ergosterol, fluconazole compromises the integrity of the fungal cell wall, leading to cell death.

Fluconazole is favored for esophageal candidiasis because it has good oral bioavailability, which makes it suitable for outpatient treatment. It is effective in both immunocompetent and immunocompromised individuals, including those with HIV/AIDS. The convenience of oral administration combined with its efficacy makes fluconazole the drug of choice for treating this specific type of candidiasis.

In contrast, voriconazole, while effective against a broader spectrum of fungi and often used in cases of invasive aspergillosis, is not the first-line treatment for esophageal candidiasis. Caspofungin is an echinocandin that is generally reserved for more severe or resistant fungal infections and is not typically used as the