Ambulatory induction phase treatment of cryptococcal meningitis in HIV integrated primary care clinics, Yangon, Myanmar.
Background: Cryptococcal meningitis (CM) is a common HIV-associated opportunistic-infection worldwide. Existing literature focusses on hospital-based outcomes of induction treatment. This paper reviews outpatient management in integrated primary care clinics in Yangon.Method: This retrospective case...
| Publicado en: | BMC Infectious Diseases Vol. 21; no. 1; pp. 1 - 7 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
BioMed Central
4/21/2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149923856&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149923856 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 4/21/2021 vid: 21 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 149923856 149923856 NLM33882845 10.1186/s12879-021-06049-z NLM33882845 149923856 ppf: 1 ppct: 6 formats: tig: atl: Ambulatory induction phase treatment of cryptococcal meningitis in HIV integrated primary care clinics, Yangon, Myanmar. aug: au: Warrell, Clare E. Macrae, Catriona McLean, Alistair R. D. Wilkins, Edmund Ashley, Elizabeth A. Smithuis, Frank Tun, Ni Ni affil: Myanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar sug: subj: AIDS-Related Opportunistic Infections Complications Meningitis, Cryptococcal Drug Therapy Human Immunodeficiency Virus Meningitis, Cryptococcal Complications Cryptococcus Immunology Amphotericin B Administration and Dosage Fluconazole Administration and Dosage Bile Acids and Salts Administration and Dosage Antifungal Agents Administration and Dosage Primary Health Care Administration, Intravenous Retrospective Design Adult Fluconazole Adverse Effects Meningitis, Cryptococcal Epidemiology Bile Acids and Salts Adverse Effects Treatment Outcomes Young Adult AIDS-Related Opportunistic Infections Epidemiology Antifungal Agents Adverse Effects Myanmar Cryptococcus Middle Age Drug Combinations Drug Therapy, Combination Phlebitis Chemically Induced Female Male Administration, Oral Amphotericin B Adverse Effects Meningitis, Cryptococcal Microbiology Adolescence AIDS-Related Opportunistic Infections Adult: 19-44 years Middle Aged: 45-64 years Adolescent: 13-18 years Female Male ab: Background: Cryptococcal meningitis (CM) is a common HIV-associated opportunistic-infection worldwide. Existing literature focusses on hospital-based outcomes of induction treatment. This paper reviews outpatient management in integrated primary care clinics in Yangon.Method: This retrospective case note review analyses a Myanmar HIV-positive patient cohort managed using ambulatory induction-phase treatment with intravenous amphotericin-B-deoxycholate (0.7-1.0 mg/kg) and oral fluconazole (800 mg orally/day).Results: Seventy-six patients were diagnosed between 2010 and 2017. The median age of patients diagnosed was 35 years, 63% were male and 33 (45%) were on concurrent treatment for tuberculosis. The median CD4 count was 60 at the time of diagnosis. Amphotericin-B-deoxycholate infusions precipitated 56 episodes of toxicity, namely hypokalaemia, nephrotoxicity, anaemia, febrile reactions, phlebitis, observed in 44 patients (58%). One-year survival (86%) was higher than existing hospital-based treatment studies.Conclusion: Ambulation of patients in this cohort saved 1029 hospital bed days and had better survival outcomes when compared to hospital-based studies in other resource constrained settings. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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