التهاب المعدة والأمعاء والتهاب الكبد بفيروس CMV: ماذا تفعل عندما لم يحقق الغانسيكلوفير تحسناً في الأعراض

References

• Foscarnet 60 mg/kg IV every 8 hours or 90 mg/kg IV every 12 hours (BIII)—for patients with treatment-limiting toxicities to ganciclovir or with ganciclovir resistance; or
• Cidofovir 5 mg/kg/week IV for 2 weeks, then 5 mg/kg IV every other week. Administer 1 L of normal saline before and, if additional fluid load can be tolerated, administer another 1 L of normal saline after cidofovir infusion. Administer probenecid 2 g PO 3 hours before each cidofovir dose followed by 1 g PO 2 hours after the dose and 1 g PO 8 hours after the dose (total of 4 g) (CI).
• Foscarnet with IV hydration should be used as an alternative if ganciclovir-related toxicity is treatment-limiting or in cases of ganciclovir-resistant virus (BIII).
• Cidofovir, administered with saline hydration before and after therapy, can be used as an alternative (CI).
• 21–42 days or until signs and symptoms have resolved (AIII).