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.
KeywordsHuman Immunodeficiency Virus Maintenance Therapy Acquire Immunodeficiency Syndrome Cryptococcus Neoformans Cryptococcal Meningitis
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