Combination antiviral therapy for ganciclovir-resistant cytomegalovirus infection in solid-organ transplant recipients

Clin Infect Dis. 2002 May 15;34(10):1337-41. doi: 10.1086/340101. Epub 2002 Apr 10.

Abstract

The resistance of cytomegalovirus (CMV) to ganciclovir is a factor in therapeutic failure and disease progression. The clinical significance of such resistance in solid-organ transplantation has not been completely established. Six patients who developed persistent infection due to ganciclovir-resistant CMV were treated with a combination of ganciclovir (50% of the therapeutic dose) and a daily dose of intravenous foscarnet that gradually increased to a maximum of 125 mg/kg. All patients responded clinically within 72-96 hours. Magnesium depletion occurred in all patients. No clinical or laboratory relapses have been observed in 6-30 months of follow-up. Gradually increasing doses of foscarnet combined with half-dose regimens of ganciclovir are safe and can be beneficial in organ transplant recipients with ganciclovir-resistant CMV infection. Larger studies are needed to identify the patients who are most likely to benefit from this regimen.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Cytomegalovirus / drug effects
  • Cytomegalovirus Infections / drug therapy*
  • Drug Resistance, Microbial
  • Drug Therapy, Combination
  • Female
  • Foscarnet / therapeutic use*
  • Ganciclovir / pharmacology
  • Ganciclovir / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Transplants*
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Foscarnet
  • Ganciclovir