Comparison of Amphotericin B, Flucytosine and ltraconazole with Amphotericin B and Flucytosine in the Treatment of Cryptococcal Meningitis in AIDS
VERAJIT CHOTMONGKOL, M.D.*, WISUT SUKEEPAISARNCHAROEN, M.D.*, YUPA THAVORNPITAK, M.Sc.**
Affiliation : * Department of Medicine, Faculty of Medicine, ** Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen 40002. Thailand.
Abstract We compared amphotericin B (0.3 mglk:g/d) plus flucytosine (150 mg/k:g/d) plus itraco- nazole (400 mg/d) (study group) with amphotericin B plus flucytosine (control group) by an open-randomized trial. In the study group, after CSF mycological cultures disclosed nothing, itra- conazole was administrated alone through six weeks of treatment. Treatment was considered suc- cessful if the patient had two consecutive negative CSF cultures by the end of the 6-week treatment period. Fifty patients were enrolled in each group. There were significant differences between the study group and the control group in the successful treatment (100% vs 90 %; P = 0.03), the mean length of time until normal body temperature after treatment (5.9 ± 3.7 days vs 8.8 ± 5.1 days; P = 0.02) and the adverse effects. The mean length of time to the first negative CSF culture was 13.9 ± 6.1 days in the study group and 13.3 ± 6.5 days in the control group ( P = 0.66). Relapse rate with itraconazole 200 mg/day was higher in the study group.
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