J Med Assoc Thai 1997; 80 (7):416

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Comparison of Amphotericin B, Flucytosine and Itraconazole with Amphotericin B and Flucytosine in the Treatment of Cryptococcal Meningitis in AIDS
Chotmongkol V Mail, Sukeepaisamcharoen W , Thavompitak Y

We compared amphotericin B (0.3 mglk:g/d) plus flucytosine (150 mg/k:g/d) plus itraconazole
(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, itraconazole
was administrated alone through six weeks of treatment. Treatment was considered successful
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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