Document Detail


Initial therapy for acquired immunodeficiency syndrome-associated cryptococcosis with fluconazole.
MedLine Citation:
PMID:  7864710     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Published opinion has generally favored amphotericin B over fluconazole as initial therapy for acquired immunodeficiency syndrome-associated cryptococcosis, although data that support this recommendation are limited. METHOD: Retrospective review of 30 consecutive patients with acquired immunodeficiency syndrome-associated cryptococcosis seen at a single institution over a 1-year period and given fluconazole, 400 mg/d, as initial therapy. RESULTS: No patient died within the first 30 days of therapy, and none of the 14 patients who died within 1 year had clinically detectable infection when last seen or at death. Pretreatment blood cultures were positive in 26 of 27 patients; cerebrospinal fluid cryptococcal antigen titer was greater than 1:1024 in 12 of 23 patients; and five of 30 patients presented with altered mental status. The median CD4 count at diagnosis was 0.042 x 10(9)/L (42/microL). Eight of 25 patients who were followed up for more than 30 days relapsed, as evidenced by a positive culture; all relapses were successfully treated with fluconazole, either by reinstitution of therapy or by increase of dosage. CONCLUSION: This experience supports the use of fluconazole as initial therapy for acquired immunodeficiency syndrome-associated cryptococcosis.
Authors:
S D Nightingale
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  155     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-03-23     Completed Date:  1995-03-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  538-40     Citation Subset:  AIM; IM; X    
Affiliation:
Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas.
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy*
Adult
Cryptococcosis / drug therapy*
Female
Fluconazole / therapeutic use*
Humans
Male
Recurrence
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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