A Comparative study on efficacy of drug regimens in treating and preventing relapse of Penicilliosis in AIDS patients

Abstract

           Upper northern Thailand was hardest hit from AIDS epidemic. One of the most important opportunistic infection found in AIDS patient in the area was Penicillium Marneffei infection. However, the treatment regimen as recommended by the Thai ministry of public health was still expensive and the new comparable regiment with lower cost needed to be validated. Objectives: To compared the efficacy of drug regimens for treatment and prevent relapse of Penicilliosis in AIDS patients. Methods: A multi center experimental study in AIDS patients aged 15 or older who were diagnosed with Penicilliosis and came to receive care at the government hospitals in Chiang Rai, Phayao, and Chiang Mai between March 2000 to March 2001. A systematic random sampling technique was used to divide the patients into two groups. The intervention group were treated with intravenous Amphotericin-B and continued with oral Ketoconazole. The control group were treated with different doses of oral Itraconazole. We monitored clinical outcomes and well as relapse rates in both groups. Results: There were 152 patients, 76 in each group, joined the study. After one year of follow-up, there was no significant different in treatment outcomes and relapse rates between the two. There were 3 relapse in treatment group accounted for 4.5/100 person-years. In control group, there was 1 relapse in treatment phase and 1 relapse in prevention phase accounted for 3.03/100 person-years. Summary, discussion, and recommendation: The comparative of recurrent rate in both group within 1 year were not different while the prophylaxis cost of the control group were more than 5 times higher than the intervention group. The health care provider should considered the intervention regimen as an alternative treatment especially in resource limited conditions.