AmB plus Fluconazole for Cryptococcal Meningitis?

In a randomized phase II study, treatment success was more likely with amphotericin B plus fluconazole than with amphotericin B alone.

Worldwide, up to 1 million cases of cryptococcosis occur annually, with most in HIV-infected individuals in developing countries. The gold standard for initial therapy of central nervous system cryptococcosis is amphotericin B (AmB) plus flucytosine. However, flucytosine requires expensive monitoring to prevent toxicity and is generally available only in developed countries. On the other hand, fluconazole is readily available, inexpensive, and relatively nontoxic. Researchers recently conducted a phase II, randomized, controlled trial in the U.S. and Thailand to examine the safety and efficacy of AmB alone and in combination with fluconazole in patients with HIV-associated cryptococcal meningitis.

Patients received one of three regimens for …

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)