Cryptococcal Meningitis in AIDS Patients A Pilot Study of Fluconazole Therapy in 52 Patients
Cryptococcal meningitis in AIDS patients is liable to relapse and carries a high mortality rate. Standard treatment with amphotericin B and 5-fluorocytosine is limited by toxic effects. In the present study 64 AIDS patients with cryptococcal meningitis were admitted to a multicentre trial of fluconazole given either orally or intravenously. After a loading dose of 400 mg, two dosage regimens were adopted: 150–200 mg, or 400 mg daily for at least 45–60 days; subsequent maintenance therapy was 100 or 200 mg daily for both groups. Forty seven of the 52 evaluable patients were alive and improved or asymptomatic at day 60 and respectively 7 of 14 and 27 of 31 of those on 200 mg or 400 mg per day had negative cultures of the cerebrospinal fluid. Relapse rate under maintenance therapy was 23%. Fluconazole was well tolerated and free from severe side effects. These results merit further study of fluconazole, either alone or in combination.
KeywordsMeningitis Candida Amphotericin Rifampicin Encephalitis
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