Oral fluconazole therapy for patients with acquired immunodeficiency syndrome and cryptococcosis: experience with 22 patients

摘要: Purpose Cryptococcus neoformans causes infections in up to 10 percent of patients with the acquired immunodeficiency syndrome (AIDS). Nearly 50 AIDS previously treated cryptococcal meningitis will experience a relapse within six months. To reduce likelihood relapse, maintenance regimen amphotericin B is often administered weekly. However, drug's intravenous route administration and considerable toxicity have led search for alternative antifungal agents. In this report, we document our fluconazole, new oral triazole agent. Patients methods Twenty-two various forms cryptococcosis were an open-label study 400 mg/day fluconazole. The following laboratory studies done on monthly basis: complete blood cell count, liver function tests, serum creatinine level, antigen fluconazole level. Lumbar puncture was performed every four eight weeks evaluate cerebrospinal fluid antigen, India ink preparation findings, fungal culture, protein, glucose, count. Results Of seven active culturepositive infections, showed clinical microbiologic responses (three meningitis, one three extraneural cryptococcosis). Fifteen who had already undergone successful therapy either (n = 14) or pneumonia 1) received as prophylaxis against relapse. Fourteen remained free infection during 11 64 suppressive therapy; patient experienced after 26 treatment. Adverse reactions limited increases hepatic enzyme levels patients. Conclusion These results appear sufficiently encouraging warrant further trials agent suppression chronic perhaps treatment acute infection.