Abstract | BACKGROUND: METHODS: RESULTS:
Neutropenia was more common in patients assigned to ganciclovir than to foscarnet (34% vs 14%; P = .001). Patients assigned to foscarnet reported more infusion-related symptoms (58% vs 24%; P < .001) and, in male patients, more genitourinary symptoms (36% vs 16%; P > .001); they also experienced a trend toward more nephrotoxic effects (13% vs 6%; P = .082) and electrolyte abnormalities. The incidence of seizures was similar in both groups ( foscarnet, 12%; ganciclovir, 9%; P = .511). Patients assigned to foscarnet were more likely to be switched to the alternative treatment ( foscarnet to ganciclovir, 46%; ganciclovir to foscarnet, 11%; P < .001), and most of this excess was attributable to toxic reactions. In 88% of cases in which treatment was switched as a result of toxic reactions and in which follow-up data were available, the toxic reaction resolved after the switch. No permanent disability or death resulted from toxic reactions. CONCLUSIONS: Compared with ganciclovir, the use of foscarnet was more frequently limited by the occurrence of toxic reactions. However, these toxic reactions rarely had long-term sequelae. In light of the previously reported survival benefit seen in patients treated with foscarnet, these data support the use of foscarnet for the initial treatment of cytomegalovirus retinitis.
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Authors | |
Journal | Archives of internal medicine
(Arch Intern Med)
Vol. 155
Issue 1
Pg. 65-74
(Jan 09 1995)
ISSN: 0003-9926 [Print] United States |
PMID | 7802522
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
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Topics |
- AIDS-Related Opportunistic Infections
(blood, drug therapy)
- Acute Kidney Injury
(chemically induced)
- Adolescent
- Adult
- Cytomegalovirus Retinitis
(blood, drug therapy)
- Foscarnet
(adverse effects, therapeutic use)
- Ganciclovir
(adverse effects, therapeutic use)
- Humans
- Male
- Neutropenia
(chemically induced)
- Odds Ratio
- Seizures
(chemically induced)
- Water-Electrolyte Imbalance
(chemically induced)
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