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, Samuel A. Bozzette

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1369-1375
Number of pages7
JournalClinical Infectious Diseases
Volume27
Issue number6
DOIs
StatePublished - Dec 1998
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Havlir, D. V., Dubé, M. P., McCutchan, J. A., Forthal, D. N., Kemper, C. A., Dunne, M. W., Parenti, D. M., Kumar, P. N., White, A. C., Witt, M. D., Nightingale, S. D., Sepkowitz, K. A., MacGregor, R. R., Cheeseman, S. H., Torriani, F. J., Zelasky, M. T., Sattler, F. R., & Bozzette, S. A. (1998). Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS. Clinical Infectious Diseases, 27(6), 1369-1375. https://doi.org/10.1086/515018