From the Guidelines
Cidofovir is not recommended for treating adenovirus infections in immunocompromised patients based on the provided evidence, as it primarily discusses the use of cidofovir for cutaneous warts, not adenovirus infections. When considering treatment for adenovirus infections in immunocompromised patients, it is crucial to prioritize therapies with established efficacy and safety profiles for this specific context.
- The provided evidence 1 focuses on the use of cidofovir for cutaneous warts, highlighting its application, dosage, and side effects in this context, but does not directly address adenovirus infections.
- Given the lack of direct evidence supporting the use of cidofovir for adenovirus infections in immunocompromised patients, alternative treatments that have been studied in this context should be considered.
- In real-life clinical practice, the management of adenovirus infections in immunocompromised patients often involves reducing immunosuppression when possible and considering antiviral therapies with proven efficacy against adenovirus.
- Close monitoring of renal function is essential when administering any potentially nephrotoxic antiviral medication, emphasizing the need for careful patient selection and monitoring.
- The use of cidofovir, as described for cutaneous warts 1, does not directly translate to the treatment of adenovirus infections, underscoring the importance of evidence-based decision-making in clinical practice.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Adenovirus Infection in Immunocompromised Patients
- Adenovirus infection can cause significant morbidity and mortality in immunocompromised patients, including those with solid organ or hematological transplants 2, 3.
- Cidofovir is a nucleoside phosphonate analogue that exhibits activity against adenovirus infection, but its use is limited due to nephrotoxicity 4, 5.
Treatment with Cidofovir
- Cidofovir has been used to treat adenovirus infection in immunocompromised patients, but its safety and efficacy in this population are not well established 4, 6.
- Studies have reported varying rates of nephrotoxicity associated with cidofovir use in pediatric patients, ranging from 9% to 78% 4, 5.
- The use of probenecid and hyperhydration may help reduce the risk of nephrotoxicity associated with cidofovir treatment 4, 6.
Alternative Treatments
- Brincidofovir, a lipid-linked derivative of cidofovir, has shown promise as a treatment for adenovirus infection in immunocompromised patients, with fewer side effects and no nephrotoxicity 2, 3.
- Adoptive T cell therapy is another potential approach to treating adenovirus infection in immunocompromised patients, particularly those with severe disease 2.
Immunocompromised Patients
- Immunocompromised patients, including those with solid organ or hematological transplants, are at increased risk of severe adenovirus infection and may require aggressive treatment 2, 3.
- The use of cidofovir or alternative treatments, such as brincidofovir, should be carefully considered in these patients, taking into account the potential risks and benefits 4, 6, 3.