Document 0102
 DOCN  M9590102
 TI    Prevention of Pneumocystis carinii pneumonia and of cerebral
       toxoplasmosis by roxithromycin in HIV-infected patients.
 DT    9509
 AU    Durant J; Hazime F; Carles M; Pechere JC; Dellamonica P; Dept. of
       Infectious Disease, University of Nice, Archet Hospital,; France.
 SO    Infection. 1995;23 Suppl 1:S33-8. Unique Identifier : AIDSLINE
       MED/95301323
 AB    The prevention of cerebral toxoplasmosis and of Pneumocystis carinii
       pneumonia is an essential objective in the management of patients
       infected with HIV. Given that roxithromycin is active in vitro against
       Toxoplasma gondii and that in 1989 Dolermann reported the effective
       treatment of P. carinii respiratory infections with erythromycin, a
       randomized pilot study was undertaken in 52 patients infected with HIV.
       Patients were treated with either: a monthly dose of pentamidine aerosol
       (300 mg); roxithromycin once a week (300 mg t.i.d.); or a combination of
       pentamidine aerosol and roxithromycin. Intention to treat analysis was
       applied to these 52 patients, all of whom received at least one
       treatment dose. Five out of 18 patients treated with pentamidine
       aerosol, 1/17 patients treated with pentamidine aerosol + roxithromycin
       and none of the 17 patients treated with roxithromycin developed
       cerebral toxoplasmosis (p = 0.038). P. carinii pneumonia was diagnosed
       in one patient in the pentamidine aerosol-treated group, in one patient
       treated with roxithromycin and in none of the patients treated with
       pentamidine aerosol + roxithromycin (non-significant difference). Four
       cases of Mycobacterium tuberculosis and Mycobacterium
       avium-intracellulare infection were seen in the pentamidine
       aerosol-treated group (p = 0.028) and none in the roxithromycin groups.
       Adverse events leading to the discontinuation of treatment occurred in
       5/34 (14.7%) patients treated with roxithromycin. Nausea, abdominal pain
       and raised transaminases occurred in four patients and a skin allergy in
       the final patient. Roxithromycin appears to be effective in the
       prevention of pulmonary pneumocystis infection and of cerebral
       toxoplasmosis in HIV-infected patients. However, these results require
       confirmation in a larger study.
 DE    Adult  Antibiotics, Combined/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*PREVENTION & CONTROL  Candidiasis/PREVENTION & CONTROL
       Comparative Study  Female  Gastrointestinal System/DRUG EFFECTS  Human
       Male  Middle Age  Mycobacterium avium-intracellulare
       Infection/PREVENTION & CONTROL  Pentamidine/ADMINISTRATION &
       DOSAGE/ADVERSE EFFECTS/*THERAPEUTIC  USE  Pilot Projects  Pneumonia,
       Pneumocystis carinii/*PREVENTION & CONTROL  Roxithromycin/ADMINISTRATION
       & DOSAGE/ADVERSE EFFECTS/  *THERAPEUTIC USE  Toxoplasmosis,
       Cerebral/*PREVENTION & CONTROL  Treatment Outcome
       Tuberculosis/PREVENTION & CONTROL  CLINICAL TRIAL  JOURNAL ARTICLE
       RANDOMIZED CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).