Pyrimethamine-clarithromycin combination for therapy of acute Toxoplasma encephalitis in patients with AIDS
Open Access
- 1 October 1991
- journal article
- Published by American Society for Microbiology in Antimicrobial Agents and Chemotherapy
- Vol. 35 (10), 2049-2052
- https://doi.org/10.1128/aac.35.10.2049
Abstract
Clarithromycin, a new macrolide, is effective in treating experimental Toxoplasma gondii infection. A pyrimethamine-clarithromycin combination was evaluated for the treatment of acute Toxoplasma encephalitis in 13 AIDS patients. The scheduled regimen was 2 g of clarithromycin per day and 75 mg of pyrimethamine per day for 6 weeks. The protocol was completed in eight patients and stopped in five patients (because of voluntary withdrawal by two patients, deterioration of neurological condition and thrombocytopenia in two patients, and suspicion of liver toxicity in one patient). The clinical and computed tomography scan responses at week 6 of treatment were 80 and 50%, respectively. Two patients died, one of toxoplasmic encephalitis and the other of cerebral bleeding due to pyrimethamine-induced thrombocytopenia. Adverse events related to therapy were nausea and/or vomiting (38%), skin rash (38%), significant increase of liver tests (24%), hearing loss (15%), and severe hematological abnormalities (31%). In this pilot study, a pyrimethamine-clarithromycin combination was shown to be comparable to the conventional regimen for the treatment of acute Toxoplasma encephalitis in AIDS patients.Keywords
This publication has 11 references indexed in Scilit:
- An Open Study of the Pyrimethamine-Clindamycin Combination in AIDS Patients with Brain ToxoplasmosisThe Journal of Infectious Diseases, 1989
- Vancomycin- and erythromycin-induced hearing loss in humansAntimicrobial Agents and Chemotherapy, 1989
- Comparative pharmacokinetics of clarithromycin (TE-031), a new macrolide antibiotic, and erythromycin in ratsAntimicrobial Agents and Chemotherapy, 1989
- Activity of A-56268 (TE-031), a new macrolide, against Toxoplasma gondii in miceJournal of Antimicrobial Chemotherapy, 1988
- In vitro effects of four macrolides (roxithromycin, spiramycin, azithromycin [CP-62,993], and A-56268) on Toxoplasma gondiiAntimicrobial Agents and Chemotherapy, 1988
- Treatment of central nervous system toxoplasmosis with pyrimethamine/sulfadiazine combination in 35 patients with the acquired immunodeficiency syndromeThe American Journal of Medicine, 1988
- Toxoplasmic EncephalitisThe Journal of Infectious Diseases, 1988
- Toxoplasma Encephalitis in Patients with Acquired Immune Deficiency Syndrome: Diagnosis and Response to TherapyThe American Journal of Tropical Medicine and Hygiene, 1987
- Drug interactions and hepatitis produced by some macrolide antibioticsJournal of Antimicrobial Chemotherapy, 1985
- OUTBREAK OF CENTRAL-NERVOUS-SYSTEM TOXOPLASMOSIS IN WESTERN EUROPE AND NORTH AMERICAThe Lancet, 1983