title: [Clarithromycin combined with pyrimethamine in cerebral toxoplasmosis--a report of 2 cases].
abstract: The authors report the use and the outcome of claritromycin associated with pyrimethamine in the treatment of toxoplasma encephalites in two patients with AIDS. Both patients had the diagnosis stablished on clinical grounds, positive sorology (IgG) for toxoplasmosis and computed-tomographic (CT) scan of the brain showing lesions consistent with T. gondii encephalitis. The two patients were initially treated with pyrimethamine and sulfadiazine, which was changed to clindamycin due to allergic reactions. These reactions (skin rash) occurred with clindamycin as well and the patients were treated with claritromycin and pyrimethamine. The scheduled regimens were 1.5 to 2 g of clarithromycin plus 25 mg of pyrimethamine. The clinical response was very good in both cases with regression of neurologic signs and encephalitic abnormalities observed on CT scan. The authors suggest that clarithromycin associated with pyrimethamine may be an alternative treatment for toxoplasmosis in AIDS patients, who cannot receive or tolerate sulfa treatment.
authors.affiliation: Disciplina de Doenças Infecciosas e Parasitárias, Hospital Universitário Antonio Pedro, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ.
authors.forename: M O
authors.initials: MO
authors.lastname: Dalston
authors.forename: W
authors.initials: W
authors.lastname: Tavares
authors.forename: A R
authors.initials: AR
authors.lastname: Bazin
authors.forename: M D
authors.initials: MD
authors.lastname: Hahn
authors.forename: A A
authors.initials: AA
authors.lastname: dos Santos
authors.forename: T
authors.initials: T
authors.lastname: Pimentel
authors.forename: J N
authors.initials: JN
authors.lastname: Mello
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000962:Antimalarials; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1; D006801:Humans; D008297:Male; D011739:Pyrimethamine / Q000008:administration & dosage*; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D000981:Antiprotozoal Agents; D017291:Clarithromycin; D011739:Pyrimethamine
vernacular_title: Claritomicina associada com pirimetamina na toxoplasmose cerebral--relato de dois casos.