Amphotericin B vs. Fluconazole for HIV-Associated Cryptococcal Meningitis

In a small study from South Africa, amphotericin B was superior in reducing fungal burden and short-term mortality; ART had no effect on 10-week mortality.

Before antiretroviral therapy (ART) became available in Africa, fluconazole was the treatment of choice for HIV-associated cryptococcal meningitis (CM), and mortality from the condition was ≥88%. Now, with improved access to ART, might outcomes be better with amphotericin B than with fluconazole? In a prospective observational study performed at a single hospital in Cape Town, South Africa, investigators addressed this question and examined the effect of ART on CM.

Participants were 54 consecutive HIV-infected adults presenting with CM. Forty-nine of the patients received intravenous amphotericin B deoxycholate at 1 mg/kg/day for 7 days, then oral fluconazole at 400 mg/day for 8 weeks; the remaining 5 patients received fluconazole at 400 mg/…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)