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

Eleftherios Mylonakis, Wendy M. Kallas, Jay A. Fishman

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1337-1341
Number of pages5
JournalClinical Infectious Diseases
Volume34
Issue number10
DOIs
StatePublished - May 15 2002

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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