Thirty-nine adult patients with human immunodeficiency virus infection and oral candidiasis were randomly assigned to receive either one fluconazole capsule (100 mg) or five clotrimazole troches (10 mg each) daily for 14 days. Among 36 evaluable patients, clinical resolution rates were 100 and 65%, respectively (P = 0.018). Mycological eradication rates were 75 and 20%, respectively (P = 0.004). Fluconazole-treated patients were more likely to remain disease free during follow-up than those treated with clotrimazole (P = 0.014 at 2 weeks). Prolonged clinical responses correlated with mycological eradication at the end of therapy (P = 0.043).