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- Title
A comparison of itraconazole versus fluconazole as maintenance therapy for AIDS-associated cryptococcal meningitis. National Institute of Allergy and Infectious Diseases Mycoses Study Group.
- Authors
Saag, M S; Cloud, G A; Graybill, J R; Sobel, J D; Tuazon, C U; Johnson, P C; Fessel, W J; Moskovitz, B L; Wiesinger, B; Cosmatos, D; Riser, L; Thomas, C; Hafner, R; Dismukes, W E
- Abstract
This study was designed to compare the effectiveness of fluconazole vs. itraconazole as maintenance therapy for AIDS-associated cryptococcal meningitis. HIV-infected patients who had been successfully treated (achieved negative culture of CSF) for a first episode of cryptococcal meningitis were randomized to receive fluconazole or itraconazole, both at 200 mg/d, for 12 months. The study was stopped prematurely on the recommendation of an independent Data Safety and Monitoring Board. At the time, 13 (23%) of 57 itraconazole recipients had experienced culture-positive relapse, compared with 2 relapses (4%) noted among 51 fluconazole recipients (P = .006). The factor best associated with relapse was the patient having not received flucytosine during the initial 2 weeks of primary treatment for cryptococcal disease (relative risk = 5.88; 95% confidence interval, 1.27-27.14; P = .04). Fluconazole remains the treatment of choice for maintenance therapy for AIDS-associated cryptococcal disease. Flucytosine may contribute to the prevention of relapse if used during the first 2 weeks of primary therapy.
- Publication
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1999, Vol 28, Issue 2, p291
- ISSN
1058-4838
- Publication type
Journal Article
- DOI
10.1086/515110