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Antimicrobial Agents and Chemotherapy, September 1998, p. 2240-2244, Vol. 42, No. 9
Departments of
Ophthalmology,1
Oncology,3
Pathology,4 and
Medicine,2 The Johns Hopkins
University School of Medicine, Baltimore, Maryland
Received 8 December 1997/Returned for modification 1 April
1998/Accepted 19 June 1998
Cytomegalovirus (CMV) retinitis is a common opportunistic infection
in patients with AIDS. With long-term therapy for CMV retinitis,
resistant CMV may develop. In a prospective study of 122 patients with
CMV retinitis, 2.4 and 0.8% of patients had foscarnet-resistant blood
culture isolates (50% inhibitory concentration [IC50],
>400 µM) and urine culture isolates, respectively, at diagnosis of
CMV retinitis prior to treatment, whereas 4.1 and 6.6% had
cidofovir-resistant (IC50, >2 µM) blood and urine
culture isolates, respectively. Patients were treated according to best medical judgement. Of 44 foscarnet-treated patients, 26% had a resistant blood or urine culture isolate by 6 months of treatment and
37% had a resistant isolate by 9 months; of 13 cidofovir-treated patients, 29% had a resistant blood or urine culture isolate by 3 months of therapy. The probabilities of developing foscarnet resistance
while on foscarnet and developing cidofovir resistance while on
cidofovir were not significantly different from that for developing
ganciclovir resistance while on ganciclovir (odds ratios, 1.87 [P = 0.19] and 2.28 [P = 0.15],
respectively).
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Incidence of Foscarnet Resistance and Cidofovir
Resistance in Patients Treated for Cytomegalovirus
Retinitis
*
Corresponding author. Mailing address: The Wilmer
Ophthalmological Institute, Suite 700, 550 N. Broadway, Baltimore, MD
21205. Phone: (410) 955-1966. Fax: (410) 955-0629. E-mail:
dajabs{at}welchlink.welch.jhu.edu.
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