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Salvage treatment of cerebral toxoplasmosis/PCP in AIDS with atovaquone.
Raise E; Rosini G; Ferlini D; Guerra L; Mazzetti M; Gritti FM; Inf. Dis.
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):382 (abstract no. PO-B10-1481). Unique

OBJECTIVES: to evaluate efficacy and tolerability of Atovaquone 566C80) in the salvage treatment of cerebral toxoplasmosis CNS-Toxo) or Pneumocystis carinii pneumonia (PCP) of AIDS patients (pt) intolerant to the usual therapies. MATERIALS AND METHODS: 566C80 was administered to 5 pt with CNS-Toxo and 1 PCP at a dose of 750 mg q.i.d. for 42 and 21 days, respectively, followed by maintenance at the same dosing. Complete clinical and laboratory evaluation of adverse events was done weekly. RESULTS: The pt with PCP had a favourable outcome and is alive on secondary prophylaxis since 1 month. Of the 5 cases of CNS-Toxo: 2 died before having completed the acute phase therapy due to associated diseases. Three showed complete clinical recovery and TC resolution of the cerebral lesions by the end of the acute treatment. Two pt survive, on maintenance therapy, after 5 and 9 months, respectively; one had a SNC-Toxo recurrency 1 month later and died of PML and toxoplasmosis. Three cases had an increase of transaminases > 10 folds of normal values, between day 25 to 30 of treatment, and in 2 the elevations could be correlated exclusively to the drug. CONCLUSIONS: Atovaquone is an alternative, secondary choice, treatment for moderate PCP and can be more extensively used in cases of AIDS-toxoplasmosis. Liver toxicity seems to be common and dosing adjustment have to be studied in order to reduce risks.

*Antifungal Agents/THERAPEUTIC USE *Antiprotozoal Agents/THERAPEUTIC USE *AIDS-Related Opportunistic Infections/DRUG THERAPY *Naphthoquinones/THERAPEUTIC USE *Pneumonia, Pneumocystis carinii/DRUG THERAPY *Toxoplasmosis, Cerebral/DRUG THERAPY