UPDATE ON THE MANAGEMENT OF INTESTINAL CRYPTOSPORIDIOSIS IN AIDS

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.