Safety of oral versus intravenous hydration during induction therapy with intravenous foscarnet in AIDS patients with cytomegalovirus infections.
We undertook a study to compare the safety of intravenous (i.v.) versus oral hydration to prevent nephrotoxicity associated with the use of foscarnet for induction therapy of cytomegalovirus (CMV) infection in HIV-infected persons. Patients, given foscarnet at a dose of 90 mg/kg every 12 h, were randomized to receive either i.v. or oral hydration. Thirty-seven patients were given i.v. hydration and 44 were given oral hydration. Median duration of therapy for both groups was 17 days. There was no difference between the 2 groups in either serious adverse events or rise of creatinine to > or = 2.0 mg/dl. However, serum creatinine, while generally remained within normal limits, increased more in patients who received oral hydration after 10 days of therapy (significant only by slope analysis, P < 0.05). Although i.v. hydration provided better protection against nephrotoxicity, oral hydration was relatively safe and convenient provided that creatinine clearance (CrCl) is monitored closely.
Cheung
T W
TW
Mount Sinai Medical Center, New York, USA. cheungtw@umdnj.edu
Jayaweera
D T
DT
Pearce
D
D
Benson
P
P
Nahass
R
R
Olson
C
C
Wool
G M
GM
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000150:complications* / Q000628:therapy; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications* / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D012965:Sodium Chloride / Q000008:administration & dosage
D000998:Antiviral Agents; D017245:Foscarnet; D012965:Sodium Chloride; D003404:Creatinine