Abstract |
We performed a randomized trial in which combination therapy with fluconazole and short-term flucytosine was compared with fluconazole monotherapy in 58 patients with AIDS-associated cryptococcal meningitis (CM). Thirty of these patients were randomized to receive combination therapy with fluconazole, 200 mg once a day for 2 months, and flucytosine, 150 mg/(kg.d) for the first 2 weeks, and 28 were randomized to receive monotherapy with fluconazole at the same dose for 2 months. Patients in both groups who survived for 2 months received fluconazole as maintenance therapy at a dose of 200 mg three times per week for 4 months. The combination therapy prevented death within 2 weeks and significantly increased the survival rate among these patients (32%) at 6 months over that among patients receiving monotherapy (12%) (P = .022). The combination therapy also resulted in a significant decrease in the severity of headache after 1 month of treatment, compared with monotherapy (P = .005). No serious adverse reactions were observed in patients receiving either regimen. These data indicate that treatment with fluconazole and short-term flucytosine is a cost-effective and safe regimen that improves the quality of life for patients with AIDS-associated CM in developing countries where human immunodeficiency virus is endemic.
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Authors | H Mayanja-Kizza, K Oishi, S Mitarai, H Yamashita, K Nalongo, K Watanabe, T Izumi, Ococi-Jungala, K Augustine, R Mugerwa, T Nagatake, K Matsumoto |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 26
Issue 6
Pg. 1362-6
(Jun 1998)
ISSN: 1058-4838 [Print] United States |
PMID | 9636863
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antifungal Agents
- Fluconazole
- Flucytosine
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Topics |
- AIDS-Related Opportunistic Infections
(drug therapy)
- Adult
- Antifungal Agents
(administration & dosage, therapeutic use)
- Drug Therapy, Combination
- Female
- Fluconazole
(administration & dosage, therapeutic use)
- Flucytosine
(administration & dosage, therapeutic use)
- Humans
- Male
- Meningitis, Cryptococcal
(drug therapy)
- Middle Aged
- Uganda
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