Comparison of the effectiveness of two treatment strategies in AIDS patients with cryptococcal meningitis
WU Qiu-yun
LU Xiang-chan
HUANG Ai-chun
HE Hua-wei
WEI Liu-ying
RUAN Guang-jing
ZHU Qing-dong
XIE Zhi-man
Abstract：Objective To investigate the rational treatment strategies for AIDS patients with cryptococcal meningitis. Methods All the patients were randomized into 2 groups with 30 in each group. Amphotericin B (AMB) and flurocytosine (5-FC) were given to the one group (AMB+5-FC group), and AMB and fluconazole (FLU) to the other group (AMB+FLU group). Therapeutic efficacy and ad-verse drug reactions were observed and compared between the 2 groups. Results After 6 weeks of treatment, clinical symptoms were improved in 49 patients, cerebrospinal fluid (CSF) India ink staining and culture were negative, and 11 patients (18.33%) were dead. The mortality rates and the negative conversion rates of CSF India ink staining and culture at different time points were not significantly different between the 2 groups (P>0.05). The common adverse drug reaction was hypokalemia in the 2 groups, with the occurrence rate of 66.67%. Bone marrow suppression was more commonly seen in AMB+5-FC group than in AMB+FLU group. Conclusions The therapeutic efficacy of AMB+5-FC and AMB+FLU in treatment of AIDS patients with cryptococcal meningitis for 6 weeks is not significantly different. However, bone marrow suppression is more likely to occur in patients receiving AMB+5-FC treat-ment, so it is suggested that combination therapy with AMB and FLU is the first option when peripheral blood abnormalities occur.
Keywords：acquired immunodeficiency syndromemeningitiscryptococcalCryptococcus neoformansamphotericin Bflucy-tosinefluconazole
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 22-24,37 )