Journal Article

Prophylaxis with Weekly Versus Daily Fluconazole for Fungal Infections in Patients with AIDS

Diane V. Havlir, Michael P. Dubé, J. Allen McCutchan, Donald N. Forthal, Carol A. Kemper, Michael W. Dunne, David M. Parenti, Princy N. Kumar, A. Clinton White, Mallory D. Witt, Stephen D. Nightingale, Kent A. Sepkowitz, Rob Roy MacGregor, Sarah H. Cheeseman, Francesca J. Torriani, Michael T. Zelasky, Fred R. Sattler and Samuel A. Bozzette

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1369-1375
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515018
Prophylaxis with Weekly Versus Daily Fluconazole for Fungal Infections in Patients with AIDS

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We compared the efficacy of a 400-mg once-weekly dosage versus a 200-mg daily dosage of fluconazole for the prevention of deep fungal infections in a multicenter, randomized, double blind trial of 636 human immunodeficiency virus-infected patients to determine if a less intensive fluconazole regimen could prevent these serious but relatively infrequent complications of AIDS. In the intent-to-treat analysis, a deep fungal infection developed in 17 subjects (5.5%) randomly assigned to daily fluconazole treatment and in 24 (7.7%) given weekly fluconazole during 74 weeks of follow-up (risk difference, 2.2%; 95% confidence interval [CI], −1.7% to 6.1%). Thrush occurred twice as frequently in the weekly versus daily fluconazole recipients (hazard ratio, 0.59; 95% CI, 0.40–0.89), and in a subset of patients evaluated, fluconazole resistance was infrequent. Fluconazole administered once weekly is effective in reducing deep fungal infections in patients with AIDS, but this dosage is less effective than the 200-mg-daily dosage in preventing thrush.

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

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