Efficacy and safety of amphotericin B combined with posaconazole in the treatment of cryptococcal meningitis complicated with AIDS
- VernacularTitle:两性霉素B联合泊沙康唑治疗艾滋病合并隐球菌性脑膜炎的有效性及安全性
- Author:
Lu ZHANG
1
;
Yanqiu LU
1
;
Dan LIU
2
;
Jing HU
2
Author Information
1. Dept. of Infection，Chongqing Public Health Medical Center，Chongqing 400030，China
2. Dept. of Pharmacy，the First Affiliated Hospital of Army Medical University，Chongqing 400038，China
- Publication Type:Journal Article
- Keywords:
cryptococcal meningitis;
human immunodeficiency virus;
amphotericin B;
posaconazole;
flucytosine;
efficacy
- From:
China Pharmacy
2024;35(16):2018-2022
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To observe the efficacy and safety of amphotericin B combined with posaconazole in the treatment of patients with AIDS combined with cryptococcal meningitis （CM）. METHODS The data of 44 patients with AIDS combined with CM admitted to Chongqing Public Health Medical Center and the First Affiliated Hospital of Army Military Medical University from January 2021 to June 2023 were collected retrospectively. They were divided into amphotericin B combined with flucytosine （AmB+FC） group and amphotericin B combined with posaconazole （AmB+POS） group according to treatment regimen， with 22 cases in each group. AmB+FC group was given Amphotericin B for injection+Flucytosine injection； AmB+POS group was given Amphotericin B for injection+posaconazole injection. After 12 weeks of treatment， clinical efficacies of two groups， clinical symptoms and the negative coversion rate of cerebrospinal fluid， and laboratory test results before and after treatment were observed in 2 groups， and the occurrence of adverse drug reactions was recorded in 2 groups. RESULTS After 12 weeks of treatment， the total effective rate， the incidences of fever， blurred vision， leukopenia， anemia， renal function abnormalities， hypokalemia， liver function abnormalities， rash， and peripheral neuropathy were compared between the two groups， and the differences were not statistically significant （P＞0.05）. The negative coversion rate of cerebrospinal fluid in AmB+POS group was significantly higher than AmB+FC group； the incidences of headache， nausea and vomiting symptoms， and the incidence of any adverse events were significantly lower than AmB+FC group （P＜0.05）. The cerebrospinal fluid pressure and cerebrospinal fluid protein content of the two groups were significantly lower than those before treatment， and the cerebrospinal fluid glucose content and cerebrospinal fluid chloride content were significantly higher than those before treatment （P＜0.05）； however， the differences were not statistically significant between 2 groups （P＞0.05）. CONCL USIONS Amphotericin B combined with posaconazole improves the negative coversion rate of cerebrospinal fluid and relieves clinical symptoms in patients with AIDS combined with CM with good safety.
