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M9550787.TXT
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1995-03-25
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Document 0787
DOCN M9550787
TI Initial therapy for acquired immunodeficiency syndrome-associated
cryptococcosis with fluconazole.
DT 9505
AU Nightingale SD; Department of Internal Medicine, University of Texas
Southwestern; Medical Center at Dallas.
SO Arch Intern Med. 1995 Mar 13;155(5):538-40. Unique Identifier : AIDSLINE
MED/95168948
AB 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.
DE Adult AIDS-Related Opportunistic Infections/*DRUG THERAPY
Cryptococcosis/*DRUG THERAPY Female Fluconazole/*THERAPEUTIC USE
Human Male Recurrence Retrospective Studies Treatment Outcome
CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).