Combination drug therapy for cryptosporidiosis in AIDS

Nathaniel H. Smith, Stanley Cron, Luis M. Valdez, Cynthia L. Chappell, A. Clinton White

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

Aside from effective antiretroviral therapy, there is no consistently effective antiparasitic therapy for cryptosporidiosis in AIDS. The purpose of this study was to assess safety, efficacy, and durability of combination therapy with paromomycin and azithromycin for chronic cryptosporidiosis. Patients with AIDS, chronic cryptosporidiosis, and < 100 CD4 cells/μL were treated with open-label paromomycin (1.0 g twice a day) plus azithromycin (600 mg once a day) for 4 weeks, followed by paromomycin alone for 8 weeks. In 11 patients, median stool frequency decreased from 6.5/day (baseline) to 4.9/day (week 4) and 3.0/day (week 12). Median reductions in 24-h oocyst excretion were 84%, 95%, and >99% at 2, 4, and 12 weeks, respectively. None of the responses were attributable to antiretrovirals. Of 5 survivors at 12- 30 months of follow-up, 3 remain asymptomatic off medications, and 2 have chronic, mild diarrhea. Treatment of cryptosporidiosis with azithromycin and paromomycin was associated with significant reduction in oocyst excretion and some clinical improvement.

Original languageEnglish (US)
Pages (from-to)900-903
Number of pages4
JournalJournal of Infectious Diseases
Volume178
Issue number3
DOIs
StatePublished - Jan 1 1998
Externally publishedYes

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ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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