Journal Article

Combination Antiviral Therapy for Ganciclovir-Resistant Cytomegalovirus Infection in Solid-Organ Transplant Recipients

Eleftherios Mylonakis, Wendy M. Kallas and Jay A. Fishman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 10, pages 1337-1341
Published in print May 2002 | ISSN: 1058-4838
Published online May 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/340101
Combination Antiviral Therapy for Ganciclovir-Resistant Cytomegalovirus Infection in Solid-Organ Transplant Recipients

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The resistance of cytomegalovirus (CMV) to ganciclovir is a factor in therapeutic failure and disease progression. The clinical significance of such resistance in solid-organ transplantation has not been completely established. Six patients who developed persistent infection due to ganciclovir-resistant CMV were treated with a combination of ganciclovir (50% of the therapeutic dose) and a daily dose of intravenous foscarnet that gradually increased to a maximum of 125 mg/kg. All patients responded clinically within 72–96 hours. Magnesium depletion occurred in all patients. No clinical or laboratory relapses have been observed in 6–30 months of follow-up. Gradually increasing doses of foscarnet combined with half-dose regimens of ganciclovir are safe and can be beneficial in organ transplant recipients with ganciclovir-resistant CMV infection. Larger studies are needed to identify the patients who are most likely to benefit from this regimen.

Journal Article.  3433 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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