A controlled trial of fluconazole or amphotericin B to prevent relapse of cryptococcal meningitis in patients with the acquired immunodeficiency syndrome

Article Abstract:

AIDS patients who have completed treatment for cryptococcal meningitis may have less risk of a relapse if they are subsequently treated with fluconazole rather than amphotericin B. Cryptococcal meningitis is an inflammation of the brain and spinal cord caused by infection with the fungus Cryptococcus neoformans. Out of 189 AIDS patients successfully treated for cryptococcal meningitis, 78 received an intravenous infusion of one milligram (mg) of amphotericin B per kilogram (kg) of body weight once a week, and 111 received 200 mg of fluconazole a day by mouth. Patients were followed for an average of 286 days. Two patients (2%) who received fluconazole had a relapse of cryptococcal disease during treatment, compared to 14 patients (18%) treated with amphotericin B. Patients in the fluconazole group had a lower risk of relapse one year after starting treatment than those in the amphotericin B group. Patients treated with amphotericin B had more drug-related side effects and bacterial infections than patients treated with fluconazole.

Diseases, AIDS patients

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Comparison of amphotericin B with fluconazole in the treatment of acute AIDS-associated cryptococcal meningitis

Article Abstract:

Fluconazole, administered orally, may be effective in treating AIDS patients who have cryptococcal meningitis. These patients are usually treated with intravenous amphotericin B. Fluconazole is a recently developed antifungal agent that is easily absorbed by the body after oral administration, penetrates the blood-brain barrier, and is effective against Cryptococcus neoformans infections. Of 194 AIDS patients with cryptococcal meningitis, 131 received oral fluconazole and 63 received amphotericin B. Treatment was effective in 40 percent of patients receiving amphotericin B and 34 percent of patients receiving fluconazole. Fourteen percent of the patients on amphotericin B and 18% of those on fluconazole died.

Complications and side effects, AIDS (Disease)

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