OBJECTIVE: To update readers on die pharmacotherapeutic management of
cryptosporidiosis in patients with AIDS. DATA SOURCES: A MEDLINE searc
h was used to identify pertinent literature. Additionally, programs an
d abstracts from the 33rd Interscience Conference on Antimicrobial Age
nts and Chemotherapy; the 1st International Conference on Macrolides,
Azalides, and Streptogramins; die 93rd American Society for Microbiolo
gy Meeting; and die 6th and 7th International Conferences on AIDS were
used. DATA EXTRACTION: Available data from in vitro, animal, and huma
n experiments were reviewed. DATA SYNTHESIS: Intestinal cryptosporidio
sis in patients with AIDS can be a life-threatening opportunistic infe
ction. However, there can be significant variability in disease expres
sion, including spontaneous remission. Supportive care with hydration
and nutritional supplementation remains a hallmark of therapy. Unfortu
nately, there is no proven specific pharmacotherapy of cryptosporidios
is in patients with AH)S. Numerous agents have been analyzed for in vi
tro activity and efficacy in experimental animal models and actual hum
an cases of the infection, including paromomycin, azidiromycin, clarid
iromycin, octreotide, hyperimmune bovine colostrum, bovine transfer fa
ctor, and many others. Because limited numbers of controlled trials ha
ve been conducted with potential therapeutic agents, the majority of d
ie information to date is preliminary in nature. CONCLUSIONS: Despite
the availability of some evolving and potentially promising treatment
modalities, further controlled clinical trials are necessary to evalua
te the role of pharmacotherapy for intestinal cryptosporidiosis in pat
ients with AIDS.