Treatment of Cryptococcal Meningitis Associated with the Acquired Immunodeficiency Syndrome
| Autor: | Jack D. Sobel, Thomas Kerkering, William E. Dismukes, Graybill, Bruce L. Moskovitz, Michael S. Saag, Carmelita U. Tuazon, Richard J. Hamill, van der Horst Cm, Gretchen A. Cloud, Philip C. Johnson, William G. Powderly |
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| Rok vydání: | 1997 |
| Předmět: | |
| Zdroj: | New England Journal of Medicine. 337:15-21 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejm199707033370103 |
| Popis: | Background Treatment with low-dose amphotericin B (0.4 mg per kilogram of body weight per day) or oral azole therapy in patients with the acquired immunodeficiency syndrome (AIDS) and cryptococcal meningitis has been associated with high mortality and low rates of cerebrospinal fluid sterilization. Methods In a double-blind multicenter trial we randomly assigned patients with a first episode of AIDS-associated cryptococcal meningitis to treatment with higher-dose amphotericin B (0.7 mg per kilogram per day) with or without flucytosine (100 mg per kilogram per day) for two weeks (step one), followed by eight weeks of treatment with itraconazole (400 mg per day) or fluconazole (400 mg per day) (step two). Treatment was considered successful if cerebrospinal fluid cultures were negative at 2 and 10 weeks or if the patient was clinically stable at 2 weeks and asymptomatic at 10 weeks. Results At two weeks, the cerebrospinal fluid cultures were negative in 60 percent of the 202 patients receiving amphotericin ... |
| Databáze: | OpenAIRE |
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