AIDS-related cryptosporidial diarrhoea: an open study with roxithromycin.
In immunocompromised patients, cryptosporidial diarrhoea is a debilitating and potentially life-threatening infection for which no effective specific therapy exists. In an uncontrolled study of 24 AIDS patients with diarrhoea exclusively due to Cryptosporidium spp., treatment with roxithromycin, 300 mg bd for 4 weeks, produced symptomatic improvement of diarrhoea in 79% of cases, with 50% of patients achieving complete response. The response rate was 100% in a subgroup of five patients with no previous or concomitant opportunistic infections. In complete responders, improvement was rapid, occurring within 3-5 days, and the duration of response was at least 6 months. Response did not appear to be correlated with the degree of immunodeficiency. The most limiting adverse effects were abdominal pain (two patients), elevated hepatic enzymes (two patients) and abdominal pain with elevated hepatic enzymes (one patient). Minor symptoms, such as gastrointestinal upset, occurred in nine patients. We conclude that roxithromycin is relatively well tolerated and effective against cryptosporidial diarrhoea in AIDS patients. Further studies to optimize dosing regimens are required.
Sprinz
E
E
Department of Internal Medicine, Hospital de Clinicas de Porto Alegre, Universidade Federal Do Rio Grande do Sul, Brazil.
Mallman
R
R
Barcellos
S
S
Silbert
S
S
Schestatsky
G
G
Bem David
D
D
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000469:parasitology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000469:parasitology*; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D003457:Cryptosporidiosis / Q000188:drug therapy*; D003458:Cryptosporidium; D003967:Diarrhea / Q000188:drug therapy* / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015575:Roxithromycin / Q000009:adverse effects / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D015575:Roxithromycin