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.
authors.affiliation: University of California, San Diego, USA.
authors.forename: D V
authors.initials: DV
authors.lastname: Havlir
authors.forename: M P
authors.initials: MP
authors.lastname: Dubé
authors.forename: J A
authors.initials: JA
authors.lastname: McCutchan
authors.forename: D N
authors.initials: DN
authors.lastname: Forthal
authors.forename: C A
authors.initials: CA
authors.lastname: Kemper
authors.forename: M W
authors.initials: MW
authors.lastname: Dunne
authors.forename: D M
authors.initials: DM
authors.lastname: Parenti
authors.forename: P N
authors.initials: PN
authors.lastname: Kumar
authors.forename: A C
authors.initials: AC
authors.lastname: White
authors.forename: M D
authors.initials: MD
authors.lastname: Witt
authors.forename: S D
authors.initials: SD
authors.lastname: Nightingale
authors.forename: K A
authors.initials: KA
authors.lastname: Sepkowitz
authors.forename: R R
authors.initials: RR
authors.lastname: MacGregor
authors.forename: S H
authors.initials: SH
authors.lastname: Cheeseman
authors.forename: F J
authors.initials: FJ
authors.lastname: Torriani
authors.forename: M T
authors.initials: MT
authors.lastname: Zelasky
authors.forename: F R
authors.initials: FR
authors.lastname: Sattler
authors.forename: S A
authors.initials: SA
authors.lastname: Bozzette
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018890:Chemoprevention; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D016019:Survival Analysis
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole