BACKGROUND:Amphotericin B treatment in cryptococcosis requires daily hospital visits or admission. Its toxicities and hospital costs have been concerned. Short course amphotericin B regimen warrants to be evaluated. OBJECTIVE: To compare the safety and efficacy of one-week (AmB1) with two-week (AmB2) amphotericin B both followed by fluconazole. MATERIAL AND METHOD: 57 AIDS with cryptococcal meningitis were randomly assigned to either AmB1 or AmB2. Microbiological and clinical clearances were the outcomes of the study. RESULTS: The treatment success at 6 weeks was 63.3% in AmB1 and 70.4% in AmB2 (p = 0.574). Clinical assessment at week 10 and renal toxicities were not significantly different between both regimens. Mortality rate was 14% however, 75% of deaths were in AmB2. CONCLUSION: AmB1 was comparably effective and safe as the standard AmB2 regimen in the treatment of AIDS related cryptococcal meningitis. It can be an alternative regimen to lower hospital based care and improve cost effective for source limiting health care centers.
RCT Entities:
BACKGROUND:Amphotericin B treatment in cryptococcosis requires daily hospital visits or admission. Its toxicities and hospital costs have been concerned. Short course amphotericin B regimen warrants to be evaluated. OBJECTIVE: To compare the safety and efficacy of one-week (AmB1) with two-week (AmB2) amphotericin B both followed by fluconazole. MATERIAL AND METHOD: 57 AIDS with cryptococcal meningitis were randomly assigned to either AmB1 or AmB2. Microbiological and clinical clearances were the outcomes of the study. RESULTS: The treatment success at 6 weeks was 63.3% in AmB1 and 70.4% in AmB2 (p = 0.574). Clinical assessment at week 10 and renal toxicities were not significantly different between both regimens. Mortality rate was 14% however, 75% of deaths were in AmB2. CONCLUSION: AmB1 was comparably effective and safe as the standard AmB2 regimen in the treatment of AIDS related cryptococcal meningitis. It can be an alternative regimen to lower hospital based care and improve cost effective for source limiting health care centers.
Authors: John R Perfect; William E Dismukes; Francoise Dromer; David L Goldman; John R Graybill; Richard J Hamill; Thomas S Harrison; Robert A Larsen; Olivier Lortholary; Minh-Hong Nguyen; Peter G Pappas; William G Powderly; Nina Singh; Jack D Sobel; Tania C Sorrell Journal: Clin Infect Dis Date: 2010-02-01 Impact factor: 9.079
Authors: Radha Rajasingham; Melissa A Rolfes; Kate E Birkenkamp; David B Meya; David R Boulware Journal: PLoS Med Date: 2012-09-25 Impact factor: 11.069
Authors: Jairo M Montezuma-Rusca; John H Powers; Dean Follmann; Jing Wang; Brigit Sullivan; Peter R Williamson Journal: PLoS One Date: 2016-08-04 Impact factor: 3.240
Authors: Jeffrey I Campbell; Steve Kanters; John E Bennett; Kristian Thorlund; Alexander C Tsai; Edward J Mills; Mark J Siedner Journal: Open Forum Infect Dis Date: 2015-02-26 Impact factor: 3.835
Authors: Tihana Bicanic; Christian Bottomley; Angela Loyse; Annemarie E Brouwer; Conrad Muzoora; Kabanda Taseera; Arthur Jackson; Jacob Phulusa; Mina C Hosseinipour; Charles van der Horst; Direk Limmathurotsakul; Nicholas J White; Douglas Wilson; Robin Wood; Graeme Meintjes; Thomas S Harrison; Joseph N Jarvis Journal: Antimicrob Agents Chemother Date: 2015-09-08 Impact factor: 5.191
Authors: David S Lawrence; Tshepo Leeme; Mosepele Mosepele; Thomas S Harrison; Janet Seeley; Joseph N Jarvis Journal: PLoS Negl Trop Dis Date: 2021-05-27
Authors: Mark W Tenforde; Adrienne E Shapiro; Benjamin Rouse; Joseph N Jarvis; Tianjing Li; Ingrid Eshun-Wilson; Nathan Ford Journal: Cochrane Database Syst Rev Date: 2018-07-25