Prophylaxis with weekly versus daily fluconazole for fungal infections in patients with AIDS

We compared the efficacy of a 400-mg once-weekly dosage versus a 200-mg dai ly dosage of fluconazole for the prevention of deep fungal infections in a multicenter, randomized, double-blind trial of 636 human immunodeficiency v irus-infected patients to determine if a less intensive fluconazole regimen could prevent these serious but relatively infrequent complications of AID S. In the intent-to-treat analysis, a deep fungal infection developed in 17 subjects (5.5%) randomly assigned to daily fluconazole treatment and in 24 (7.7%) given weekly fluconazole during 74 weeks of follow-up (risk differe nce, 2.2%; 95% confidence interval [CI], -1.7% to 6.1%), Thrush occurred tw ice as frequently in the weekly versus daily fluconazole recipients (hazard ratio, 0.59; 95% CI, 0.40-0.89), and in a subset of patients evaluated, fl uconazole resistance was infrequent. Fluconazole administered once weekly i s effective in reducing deep fungal infections in patients with AIDS, but t his dosage is less effective than the 200-mg-daily dosage in preventing thr ush.