3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:158. Unique
Current experience on fluconazole (F) for cryptococcal meningitis in
AIDS patients (pts) is based on doses lower than 10 mg/kg/day (400-600
mg/day for induction and 200-400 mg/day for maintenance therapy).
However, it can be hypothesized that higher doses may be associated to
improved clinical outcome. To verify this hypothesis, we administered F
for induction therapy of cryptococcal meningitis at doses greater than
10 mg/kg to 14 AIDS pts. The dosage regimen was subsequently reduced for
maintenance therapy. Concomitant samples of cerebrospinal fluid (CSF)
and serum were obtained from 13 pts at different time intervals and
dosage regimens during treatment. Serum and CSF were obtained 5 times in
2 pts, 3 times in 4 pts, 2 times in 5 pts e 1 time in 2 pts.
Approximately 1/3 of the samples was obtained following i.v.
administration while 2/3 following oral administration. Levels of F,
determined by HPLC, were as Follows:(Table: See Text). Concentrations of
F increased linearly and significantly with respect to the administered
dose (serum: p = 0.006, CSF: p = 0.003, Kruskal - Wallis). Our study
provides a pharmacokinetic base to the possibility of administering F at
high doses to AIDS pts with cryptococcal meningitis.
Acquired Immunodeficiency Syndrome/*COMPLICATIONS Antifungal
Agents/ADMINISTRATION & DOSAGE/BLOOD/*CEREBROSPINAL FLUID/THERAPEUTIC
USE Chromatography, High Pressure Liquid Dose-Response Relationship,
Drug Fluconazole/ADMINISTRATION & DOSAGE/BLOOD/*CEREBROSPINAL FLUID/
THERAPEUTIC USE Human Meningitis, Cryptococcal/*DRUG THERAPY ABSTRACT