Combination Therapy with Fluconazole and Flucytosine for Cryptococcal Meningitis in Ugandan Patients with AIDS
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Date
1998
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Infectious Diseases
Abstract
We 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.
Description
Keywords
hiv, acquired immunodeficiency syndrome, cryptococcal meningitis, cost effectiveness, flucytosine, headache, combined modality therapy, developing countries, fluconazole,survival rate, quality of life
Citation
Kizza, H. M., Oishi, K., Mitarai, S., Yamashita, H., Nalongo, K., Watanabe, K., ... & Matsumoto, K. (1998). Combination therapy with fluconazole and flucytosine for cryptococcal meningitis in Ugandan patients with AIDS. Clinical Infectious Diseases, 26(6), 1362-1366.https://doi.org/10.1086/516372