In resource-limited settings where 5-FC is not available, high-dose fluconazole in combination with amphotericin B may be an alternative option for induction therapy.
Cryptococcal meningitis (CM) is one of the leading causes of AIDS-related mortality in sub-Saharan Africa. The currently recommended therapy for CM is amphotericin B (AmB) plus 5-flucytosine (5-FC); however, 5-FC is not available in many resource-limited settings. Fluconazole is an attractive alternative to 5-FC because it is inexpensive and widely available, but its relative efficacy is still under evaluation. Now, data from a small randomized trial suggest that the two drugs might be comparable.
Eighty antiretroviral-naive HIV-infected patients in South Africa with their first episode of CM were randomized to receive one of four induction treatment regimens: AmB plus 5-FC, AmB plus fluconazole (at 600 mg twice daily or 800 mg daily), or Am…
Reviewing Authors
A. Tariro Makadzange, MD, PhD
A. Tariro Makadzange, MD, PhD
DisclosuresGrant/Research SupportNIH
Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)
Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)
DisclosuresGrant/Research SupportNIH
Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)
Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)