Foscarnet, administered via a central line, was used for the treatment of 18 episodes of cytomegalovirus (CMV) esophageal ulceration in 15 patients, and in the treatment of 27 episodes of CMV
colitis in 22 patients. In 15 of the 18 episodes of the
esophageal disease, there was complete loss of symptoms within 2 wk. Only three of the 15 patients responding to
foscarnet therapy had a relapse of their
esophageal disease. Two of these patients were successfully retreated with
foscarnet. Of the 22 patients receiving
foscarnet for CMV
colitis, four died during
foscarnet therapy. Of the 18 patients completing the course of treatment with
foscarnet for first-episode CMV
colitis, 11 remitted completely and six had a partial remission. All patients with partial remission had a second pathogen responsible for the continuation of their
diarrhea. Only one patient completing a course of
foscarnet failed to respond microscopically to treatment. Three patients experienced relapse of their CMV
colitis, two of whom responded to further courses of
foscarnet.
Foscarnet is an effective
therapy for CMV disease of the gastrointestinal tract, with rapid resolution of clinical symptoms, long-term remission of
esophageal disease, and shorter disease-free periods for CMV
colitis.