RUSH DESENSITIZATION TO CLINDAMYCIN OF AIDS PATIENTS TREATED FOR TOXOPLASMIC ENCEPHALITIS

The use of pyrimethamine plus clindamycine has been validated as an ef fective treatment of toxoplasmic encephalitis in AIDS patients : this combination was assessed in 21 patients (10 in first intention therapy , 11 as an alternative regimen to pyrimethamine plus sulfadiazine). In the ten first days of treatment 7 patients experienced a mild to seve re skin rash with fever which resolved after discontinuation of clinda mycin. A one-day specific desensitization regimen was completed under careful monitoring: the initial dose of intravenous clindamycine was 0 ,15 mg. The dosage was two-fold increased every hour so as to get the 1,2 g unit dose after 18 hours. In 6 of the 7 patients the clinical to lerance of the regimen was good and the pyrimethamine -clincamycin com bination could so be completed not only for acute but also for mainten ance therapy. On the other hand, in one patient, the occurence of a ne w rash during the desensitization led us to stop the test. These data suggest that rush desensitization to clindamycin could be used to allo w AIDS patients who experienced clindamycin related skin rash to compl ete bitherapy regimen of toxoplasmic encephalitis.