Effects of combination therapy with low dose fluconazole and flucytosine against cryptococcal; meningitis (CM) in patients in Uganda

ABSTRACT

From January through July 1994; 58 AIDS patients were enrolled at Mulago Hospital; Makerere Medical School. Of these 58 patients; 30 were assigned to a primary therapy with fluconazole (FLCZ) at a dose of 200mg/day for 2 months and flucytosine (5FC; 150/mg/Kg) for 2 weeks and 28 were assigned to month therapy with FLCZ at the same doze. All the patients who survived for 2 months continued to administrate FLCZ at a doze of 200mg three times per week as a maintenance therapy for 4 months. Fifty patients were evaluated for the survival rate at the end of the therapy for six months. The combination therapy prevented the early death of these patients; while half of patients who received monotherapy died within the first two weeks. The survival rate (32) of 25 patients receiving the combination therapy was significantly higher than that (12) of 25 patients receiving the monotherapy at the end of therapy for 6 months (P0.05). No serious adverse reactions were observed. These data suggest the combination therapy with low dose FLCZ and short course 5FC is cost-effective and safe regimen against CM in AIDS patients in developing countries