Intravenous Foscarnet for the Treatment of Severe Cytomegalovirus Infection in Allograft Recipients

Klintmalm, Göran B.; Lönnqvist, B; Öberg, Bo; Gahrton, Göst; Lernestedt, John-Olof; Lundgren, G; Ringdén, Olle; Robért, Karl‐Henrik; Wahrén, Britta; Groth, Carl‐Gustav

doi:10.3109/13813458509061661

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its antiviral effect is believed to be due primarily to selective inhibition of viral DNA polymerases or reverse transcriptase. Clinical experience with this agent has shown it to provide some benefit for the treatment of cytomegalovirus infections in immunocompromised patients such as bone marrow and renal transplant recipients (8) and patients with the acquired immunodeficiency syndrome (AIDS) (3,7,14). In addition, research under way to evaluate its effectiveness in treating underlying human immunodeficiency viral infection shows promising results (4,6).…”

mentioning

confidence: 99%

Pharmacokinetics of intermittently administered intravenous foscarnet in the treatment of acquired immunodeficiency syndrome patients with serious cytomegalovirus retinitis

Aweeka

Gambertoglio

Mills

et al. 1989

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Foscarnet has been shown to be active in vitro against the human immunodeficiency virus and all human herpesviruses including cytomegalovirus (CMV). A pharmacokinetic study was carried out as part of a clinical trial designed to evaluate the safety and efficacy of intermittently administered intravenous foscarnet for the treatment of CMV retinitis. Eight patients with acquired immunodeficiency syndrome and serious CMV retinitis received 2-h intravenous infusions of foscarnet at a dosage of 60 mg/kg of body weight every 8 h for 14 days. Serial plasma samples were collected on days 3 and 14 of therapy, and foscarnet concentrations were determined by high-pressure liquid chromatography. On day 3 of therapy, the mean (+ standard deviation) peak and trough levels in plasma were 509 (200) and 98 (29) iiM, respectively, while on day 14 levels were 495 (149) and 126 (59) ,uM. The mean clearance in plasma on days 3 and 14 were 1.9 (0.6) and 1.7 (0.9) mi/min per kg, respectively. On day 14, the mean half-life was 4.5 (1.2) h and the volume of distribution was 0.74 (0.60) liter/kg. As the half-life and the clearance of foscarnet in plasma correlated with changes in renal function, dosage adjustments must be made for patients with decreased renal function.

show abstract

mentioning

confidence: 99%

Pharmacokinetics of intermittently administered intravenous foscarnet in the treatment of acquired immunodeficiency syndrome patients with serious cytomegalovirus retinitis

Aweeka

Gambertoglio

Mills

et al. 1989

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Clinical experience in patients treated with intravenous foscarnet for opportunistic CMV infections suggests a beneficial effect (9,12,20).…”

mentioning

confidence: 99%

Pharmacokinetics of foscarnet and distribution to cerebrospinal fluid after intravenous infusion in patients with human immunodeficiency virus infection

Sjövall

Bergdahl

Movin

et al. 1989

Antimicrob Agents Chemother

View full text Add to dashboard Cite

To investigate the pharmacokinetics and effects of intravenous foscarnet, 13 relatively healthy male patients with human immunodeficiency virus infection and a mean CD4+ lymphocyte value of 0.45 x 10-9 cells per liter were given a continuous intravenous infusion of foscarnet (0.14 to 0.19 mg/kg per min) for 8 to 21 days. Blood and urine samples were taken during and after drug administration to monitor foscarnet concentrations. Lumbar puncture was performed during the infusion in five patients. The concentrations in plasma showed large variations both within and between patients. The disposition of foscarnet could be explained by a triexponential equation (tl2,1, 0.40 to 2.52 h; t112X, 3.20 to 16.7 h; tl/2J3, 36 to 196 h). Renal clearance accounted for most of the plasma clearance, the dilerence probably reflecting the passage of foscarnet into bone. Up to 20% of the cumulative dose may have been deposited in bone 7 days postinfusion. Foscarnet was distributed to the cerebrospinal fluid in a concentration varying from 13 to 68% of the simultaneous concentration in plasma. Polyuria and polydipsia were recorded in all patients. There appears to be an association between the degree of malaise, including symptoms such as nausea, vomiting, fatigue, and headache, and concentrations in plasma above 350 ,umol/liter.

show abstract

“…lt must be given intravenously at 3-7 mg/kg per hour for 4-21 days in order to maintain a plasma level of 30-50 j.Lg/ml (100-165 ~J.mol/liter). Klintmalm et al ( 1985) treated six immunosuppressed patients with life-threatening CMV infection in this manner and observed favorable responses in five. treated 57 episodes of CMV infection in 13 bone marrow and 33 renal transplant recipients.…”

Section: Phosphonoformic Acidmentioning

confidence: 99%

Cytomegalovirus

1991

View full text Add to dashboard Cite

All rights reserved 90-14345 CIP No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Preface to the First EditionAlthough there are a number of excellent current reviews on one or another aspect of cytomegalovirus, the last comprehensive treatment of this subject was that of Krech et al. (197la). In view of the amazing advances in the virological, epidemiologic, and clinical knowledge of cytomegaloviruses, an up-to-date book is needed. Such a work should cover many areas of expertise and a voluminous technical literature. Each area might have been reviewed and analyzed by workers more expert than myself. However, I have embarked on the entire venture alone in order to attain unity and continuity in this book, characteristics that are not easily achieved in the more popular multiauthored works. I have tried to review the Iiterature and provide a critical summary for each area discussed. To do this, I provide as much of the primary data of the relevant works as needed and not just the qualitative conclusions. Inevitably, the flow of the narrative may be interrupted by dry facts and figures. However, such information is essential to make this a meaningful reference work. But for those not interested in such details, I have provided at what I hope are crucial points critiques and summaries.This book is not an exhaustive review of all the literature. This is probably no Ionger possible or even desirable. By selection, however, one runs the risk of having missed or ignored important papers. I am keenly aware of this, and I wish to apologize for such oversight, if that is possible.I visualize this work as being useful for physicians, scientists, and students interested in the biology of and infection by human cytomegalovirus. I feel that to understand these, the basic virology of this virus and related herpesviruses must be included. Topics that have not advanced a great deal and that are adequately described in available works, such as the anatomic pathology, have not been reviewed in detail. The emphasis has been placed on newer insights in the virology, immunology, serology, epidemiology, and especially clinical aspects of human cytomegalovirus. I wish tobring out the interactions of knowledge in these areas. Part II is a much shorter treatment of the nonhuman cytomegaloviruses, reviewed primarily from the point of view of their contribution to the understanding of the human virus. V vi Preface to the First Edition Finally, I wish to thank Drs. Charles R. Rinaldo, Jr., John A. Armstrong, and Donald N. Medearis for their critical review of the manuscript. Their suggestions were invaluable. Dr. John N. Dowling's thorough review of CMV infection in patients with malignancies was the basis of Section 13.4. I also acknowledge the indispensable and patient secretarial assistance of Ms.The remarkable medical events and advances in knowle...

show abstract

Intravenous Foscarnet for the Treatment of Severe Cytomegalovirus Infection in Allograft Recipients

Cited by 3 publications

References 0 publications

Pharmacokinetics of intermittently administered intravenous foscarnet in the treatment of acquired immunodeficiency syndrome patients with serious cytomegalovirus retinitis

Pharmacokinetics of intermittently administered intravenous foscarnet in the treatment of acquired immunodeficiency syndrome patients with serious cytomegalovirus retinitis

Pharmacokinetics of foscarnet and distribution to cerebrospinal fluid after intravenous infusion in patients with human immunodeficiency virus infection

Cytomegalovirus

Contact Info

Product

Resources

About