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Usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment.

AbstractINTRODUCTION:
Cryptococcal meningitis is a severe infection among immunosuppressed individuals, with a high mortality rate. Although amphotericin B is the first-choice drug for treatment, its use is restricted when adverse effects are clinically problematic. The usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment has been unconfirmed. We evaluated the efficacy of intraventricular infusion of amphotericin B through Ommaya reservoirs.
MATERIALS AND METHODS:
We retrospectively analyzed 10 consecutive patients with cryptococcal meningitis who were refractory to systemic administration of antifungal drugs.
RESULTS:
Fever or nausea occurred in most patients. However, no patient complained of serious complications such as renal toxicity. Seven patients recovered completely or partially, whereas three patients died.
CONCLUSIONS:
To establish the efficacy of the intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis, a prospective investigation should be designed to compare those treated according to the updated guidelines and those treated with antifungal drugs through the Ommaya reservoirs.
AuthorsTatsuya Nakama, Satoshi Yamashita, Tomoo Hirahara, Sadahisa Okamoto, Shoji Honda, Masaki Watanabe, En Kimura, Makoto Uchino, Shigetoshi Yano, Jun-ichi Kuratsu, Yukio Ando
JournalJournal of the neurological sciences (J Neurol Sci) Vol. 358 Issue 1-2 Pg. 259-62 (Nov 15 2015) ISSN: 1878-5883 [Electronic] Netherlands
PMID26362338 (Publication Type: Journal Article)
CopyrightCopyright © 2015 Elsevier B.V. All rights reserved.
Chemical References
  • Antifungal Agents
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents (administration & dosage, therapeutic use)
  • Drug Delivery Systems
  • Female
  • Humans
  • Male
  • Meningitis, Cryptococcal (drug therapy)
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

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