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

doi:10.1086/515018

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

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63 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 language	English (US)
Pages (from-to)	1369-1375
Number of pages	7
Journal	Clinical Infectious Diseases
Volume	27
Issue number	6
DOIs	https://doi.org/10.1086/515018
State	Published - Dec 1998
Externally published	Yes

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1086/515018

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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

Havlir, DV, Dubé, MP, McCutchan, JA, Forthal, DN, Kemper, CA, Dunne, MW, Parenti, DM, Kumar, PN, White, AC, Witt, MD, Nightingale, SD, Sepkowitz, KA, MacGregor, RR, Cheeseman, SH, Torriani, FJ, Zelasky, MT, Sattler, FR & Bozzette, SA 1998, 'Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS', Clinical Infectious Diseases, vol. 27, no. 6, pp. 1369-1375. https://doi.org/10.1086/515018

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title = "Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS",

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.",

author = "Havlir, \{Diane V.\} and Dub{\'e}, \{Michael P.\} and McCutchan, \{J. Allen\} and Forthal, \{Donald N.\} and Kemper, \{Carol A.\} and Dunne, \{Michael W.\} and Parenti, \{David M.\} and Kumar, \{Princy N.\} and White, \{A. Clinton\} and Witt, \{Mallory D.\} and Nightingale, \{Stephen D.\} and Sepkowitz, \{Kent A.\} and MacGregor, \{Rob Roy\} and Cheeseman, \{Sarah H.\} and Torriani, \{Francesca J.\} and Zelasky, \{Michael T.\} and Sattler, \{Fred R.\} and Bozzette, \{Samuel A.\}",

note = "Funding Information: Received 18 February 1998; revised 23 June 1998. This work was presented in part at The Third Conference on Retroviruses and Opportunistic Infections, held in Washington, D.C., 28 January to 1 February 1996 [abstract 567]. Financial support: The California University-Wide AIDS Research Program, through the California Collaborative Treatment Group (CCTG; no. CC94-SD-136), Pfizer Central Research, and Adria Laboratories, Inc. Dr. Bozzette is a Health Services Research \& Development Senior Research Associate of the Department of Veterans Affairs. Reprints or correspondence: Dr. Diane Havlir, University of California, San Diego, UCSD Treatment Center, 2760 Fifth Avenue, Suite 300, San Diego, California 92103.",

year = "1998",

month = dec,

doi = "10.1086/515018",

language = "English (US)",

volume = "27",

pages = "1369--1375",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "6",

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T1 - Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS

AU - Havlir, Diane V.

AU - Dubé, Michael P.

AU - McCutchan, J. Allen

AU - Forthal, Donald N.

AU - Kemper, Carol A.

AU - Dunne, Michael W.

AU - Parenti, David M.

AU - Kumar, Princy N.

AU - White, A. Clinton

AU - Witt, Mallory D.

AU - Nightingale, Stephen D.

AU - Sepkowitz, Kent A.

AU - MacGregor, Rob Roy

AU - Cheeseman, Sarah H.

AU - Torriani, Francesca J.

AU - Zelasky, Michael T.

AU - Sattler, Fred R.

AU - Bozzette, Samuel A.

N1 - Funding Information: Received 18 February 1998; revised 23 June 1998. This work was presented in part at The Third Conference on Retroviruses and Opportunistic Infections, held in Washington, D.C., 28 January to 1 February 1996 [abstract 567]. Financial support: The California University-Wide AIDS Research Program, through the California Collaborative Treatment Group (CCTG; no. CC94-SD-136), Pfizer Central Research, and Adria Laboratories, Inc. Dr. Bozzette is a Health Services Research & Development Senior Research Associate of the Department of Veterans Affairs. Reprints or correspondence: Dr. Diane Havlir, University of California, San Diego, UCSD Treatment Center, 2760 Fifth Avenue, Suite 300, San Diego, California 92103.

PY - 1998/12

Y1 - 1998/12

N2 - 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.

AB - 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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Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS

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