Nursing Considerations in the use of Cidofovir for CMV Retinitis in Patients with AIDS: Report of a Roundtable Meeting

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S1055-3290(97)80030-1 Byline: Maureen A. Martin (a), Carol Kane (b) Abstract: Cytomegalovirus (CMV) retinitis, a late complication of infection with HIV, generally leads to blindness if untreated. Although the retinal damage from CMV cannot be reversed, disease progression can be arrested with any one of three antiviral agents, which must be continued indefinitely. Intravenous ganciclovir and foscarnet, the earliest therapies, must be administered every day and require placement of an indwelling catheter. Cidofovir, a newly introduced intravenous antiviral, requires the least frequent administration; after two once-a-week induction doses maintenance therapy is given only once every other week. However, cidofovir is potentially nephrotoxic and must be coadministered with nephroprotective probenecid and saline hydration. Careful adherence to treatment administration guidelines for cidofovir and probenecid is essential for safe administration of both drugs. Averting and managing adverse reactions to cidofovir and probenecid may present a true nursing challenge; however, with proper patient selection and appropriate use, cidofovir has the potential to greatly enhance the quality of life of a patient with CMV retinitis. Author Affiliation: (a) Department of Medicine, UCLA Medical Center, Center for Clinical AIDS Research and Education USA (b) Santa Clara Valley Medical Center USA