High-Dose Fluconazole Therapy for Cryptococcal Meningitis in Patients with AIDS
| Autor: | Dante Bassetti, Maurizio Fiorio, Franca Miletich, S. Pauluzzi, Maria Bruna Pasticci, Massimo Marroni, Giorgio Gatti, Andrea Tosti, Francesco Menichetti |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Antifungal Agents Antigens Fungal Time Factors Cryptococcal medicine.medical_treatment Meningitis Cryptococcal Gastroenterology Cerebrospinal fluid Internal medicine medicine Humans Meningitis Antigens Fluconazole Mycosis Aged Chemotherapy AIDS-Related Opportunistic Infections business.industry Mortality rate Drug Tolerance Middle Aged medicine.disease Surgery Cryptococcus Fungal Infectious Diseases Cryptococcosis Female Complication business medicine.drug |
| Zdroj: | Clinical Infectious Diseases. 22:838-840 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/clinids/22.5.838 |
| Popis: | Fluconazole (800-1,000 mg i.v.) was administered to 14 consecutive patients with AIDS and cryptococcal meningitis. At 10 weeks the rate of clinical success was 54.5% (six of 11 patients responded to fluconazole); the Kaplan-Meier estimate of the response rate was 67.1%, and the overall mortality rate was 18.2% (two of 11 patients died). At the end of treatment, eight (72.7%) of 11 patients responded to fluconazole. The median time to the first negative cerebrospinal fluid (CSF) culture was 33.5 days (95% confidence interval, 18.3-67.3); the median time for patients with initial CSF cryptococcal antigen titers of > or = 1:1,024 was 66 days compared with 18 days for patients with initial CSF cryptococcal antigen titers of < 1:1,024 (P = .06). The median time to the first negative CSF culture for patients with an isolate for which the minimum inhibitory concentration (MIC) was 4 micrograms/mL was 56 days compared with 16 days for patients with an isolate for which the MIC was < 4 micrograms/mL (P = .11). The mean serum and CSF levels of fluconazole at steady state were 42.47 +/- 26.31 micrograms/mL and 36.63 +/- 21.08 micrograms/mL, respectively (ratio of CSF:serum, 0.86). No treatment was interrupted and no dose was tapered because of side effects. High-dose fluconazole might be an effective and well-tolerated therapeutic option for patients with AIDS and acute cryptococcal meningitis. |
| Databáze: | OpenAIRE |
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