PMID: 3767546Oct 1, 1986Paper

Survival improvement in coccidioidal meningitis by high-dose intrathecal amphotericin B

Archives of Internal Medicine
E L Labadie, R H Hamilton

Abstract

Eleven patients with coccidioidal meningitis were treated with high individual doses (1.0 to 1.5 mg) of intrathecal amphotericin B mixed with 25 to 50 mg of hydrocortisone in an attempt to reach a dose of 12 mg per month for at least two consecutive months. Patients received a mean intrathecal dose of amphotericin B of 82 mg (range, 40 to 157 mg) and 2.4 g intravenously (range, 1.0 to 3.5 g). No deaths related to disease or treatment occurred, and overall survival was 91% during an average follow-up period of 75 months (range, 30 to 137 months). Comparative analysis with eight well-known series in the literature reveals that our survival rate and follow-up time are significantly greater than the more recent series (1977-1981). Rank correlation and linear regression showed that the mean intrathecal dose of amphotericin B used in all series corresponds well with mean survival time. Our clinical results and analysis of the literature suggest that intrathecal amphotericin B administered at a high dose rate of 0.75 mg (or greater) three times per week promptly reaching 20 mg and a total surpassing 40 mg is associated with significantly enhanced survival rates.

Citations

May 19, 2000·Antimicrobial Agents and Chemotherapy·K N SorensenP L Williams
Dec 21, 2006·Antimicrobial Agents and Chemotherapy·Perparim KamberiDavid A Stevens
Feb 15, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·H M HagmanR E Bryant
Apr 19, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J N GalgianiP L Williams
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Oct 16, 2015·Revista Do Instituto De Medicina Tropical De São Paulo·Neil M Ampel
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Jan 29, 2005·Current Treatment Options in Neurology·Larry E Davis, Beth S Porter
Jan 24, 2012·Journal of the American Animal Hospital Association·Martin YoungMathew Williams

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