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Evidence summaries

Management of Toxoplasmic Encephalitis in HIV-Infected Adults

There appears to be no significant differences in the effects of pyrimethamine plus sulfadiazine versus pyrimethamine plus clindamycin or trimethoprim-sulfamethoxazole on mortality or cure rates in the management of toxoplasmic encephalitis in HIV-infected adults. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 3 studies with a total of 335 subjects. Two trials compared pyrimethamine plus sulfadiazine (P+S) with pyrimethamine plus clindamycin (P+C). One trial compared P+S with trimethoprim-sulfamethoxazole (TMP-SMX). All three studies were relatively small and did not show significant differences in the treatment effects between the different drug regimens.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

    References

    • Dedicoat M, Livesley N. Management of toxoplasmic encephalitis in HIV-infected adults (with an emphasis on resource-poor settings). Cochrane Database Syst Rev 2006 Jul 19;3:CD005420. [PubMed]

Primary/Secondary Keywords