A Study of Spiramycin in the Treatment of Patients With AIDS-Related Diarrhea

Inclusion Criteria Concurrent Medication: Allowed: Vitamin supplements. Zidovudine (AZT) for patients previously taking AZT. However, dosing with spiramycin should be delayed until the dose of AZT has stabilized. The dose may be decreased for AZT-associated toxicity. Allowed for diarrhea: Loperamide hydrochloride capsules (2 mg) or loperamide hydrochloride liquid (1 mg/5 ml). Allowed for nausea: Sucralfate and metoclopramide hydrochloride. Allowed for vomiting: Prochlorperazine and trimethobenzamide hydrochloride. Allowed as prophylaxis for Pneumocystis carinii pneumonia (PCP): Aerosolized pentamidine. Patients must have: A diagnosis of AIDS according to the CDC. Chronic diarrhea. Presence of Cryptosporidium oocysts in stool specimen. Patients or a legally authorized representative must sign an informed consent form. Diet will be lactose free, maximum 7 g fat/day with unlimited calorie intake. Patients who require total parenteral nutrition will also be allowed oral intake. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: Grade 4 (for hematologic) or Grade 3 (for all other) toxicity. Known sensitivity to macrolide antibiotics. Presence of other diarrhea-causing pathogens. Active opportunistic infection requiring systemic antimicrobial therapy. Toxicity grades according to NIAID toxicity scale for adults. Concurrent Medication: Excluded: Other investigational drugs. Cancer chemotherapy. Alpha interferon. Other immunomodulating agents. Other macrolide antibiotics. Trimethoprim / sulfamethoxazole. Ganciclovir. H2 blockers and AL-721. Medications known to cause gastrointestinal irritation or alteration of gastrointestinal motility or absorption should be avoided if possible. Zidovudine (AZT) therapy may not be initiated and the dose may not be increased during the study. Patients with the following are excluded: Grade 4 (for hematologic) or Grade 3 (for all other) toxicity. Known sensitivity to macrolide antibiotics. Presence of other diarrhea-causing pathogens. Active opportunistic infection requiring systemic antimicrobial therapy. Toxicity grades according to NIAID toxicity scale for adults. Prior Medication: Excluded within 7 days of study entry: Investigational drugs. Excluded within 14 days of study entry: Cancer chemotherapy. Alpha interferon. Other immunomodulating agents. Other macrolide antibiotics. Trimethoprim / sulfamethoxazole. Ganciclovir.