Animal studies and case series have demonstrated the dose-dependent efficacy and long half-life of amphotericin Bdeoxycholate (ABd), providing the rationale for our randomized controlled study to compare once-daily (OD) (1 mg/kg)and alternate-d (AD) (2 mg/kg) administration of ABd in the treatment of cryptococcal meningitis in patients with AIDShospitalized at King Chulalongkorn Memorial Hospital, Thailand, from 2003 to 2004. Of 28 patients, 15 and 13 receivedOD and AD administration, respectively. There was no significant difference between the 2 groups regarding thedemography, clinical features, and laboratory data. After 2 weeks of the intensive-phase treatment, there was no significantdifference in the clinical response between the OD (80%) and AD (76.9%) groups. Mycological response was observed in33.3% and 10% of patients in the OD and AD groups, respectively (p
0.3). There was no difference in nephrotoxicity and infusion-related events. In conclusion, this is the first randomized controlled study comparing OD and AD administration ofABd in the treatment of cryptococcal meningitis. Although our study was not sufficiently powered to draw conclusions onclinical efficacy and toxicities, the results are encouraging and should warrant further clinical trials evaluating the efficacyand adverse effects with a larger sample size.

Scandinavian Journal of Infectious Diseases ปี 2550, ปีที่: 39 ฉบับที่ 10 หน้า 896 - 901