Browsing by Author "Nalongo, Kisembo"
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Item Combination Therapy with Fluconazole and Flucytosine for Cryptococcal Meningitis in Ugandan Patients with AIDS(Clinical Infectious Diseases, 1998) Kizza, Harriet Mayanja; Oishi, Kazunori; Mitarai, Satoshi; Yamashita, Hiroshi; Nalongo, Kisembo; Watanabe, Kiwao; Izumi, Takashi; Jungala, Ococi; Augustine, Kaddhu; Mugerwa, Roy; Nagatake, Tsuyoshi; Matsumoto, KeizoWe performed a randomized trial in which combination therapy with fluconazole and shortterm 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 AIDSassociated CM in developing countries where human immunodeficiency virus is endemic.