Fungal burden, early fungicidal activity, and outcome in cryptococcal meningitis in antiretroviral-naive or antiretroviral-experienced patients treated with amphotericin B or fluconazole

Clin Infect Dis. 2007 Jul 1;45(1):76-80. doi: 10.1086/518607. Epub 2007 May 25.

Abstract

In a prospective observational study of 54 patients with human immunodeficiency virus-associated cryptococcal meningitis, the early fungicidal activity of amphotericin B (1 mg/kg/day) was significantly greater than that of fluconazole (400 mg/day). Compared with antiretroviral therapy-naive patients, patients developing cryptococcal meningitis while already receiving antiretroviral therapy had lower baseline fungal burdens and a longer median duration of survival, but there were no differences observed in fungal clearance, cerebrospinal fluid proinflammatory cytokines, or 10-week mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / mortality
  • Adult
  • Amphotericin B / therapeutic use*
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Fluconazole / therapeutic use*
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Male
  • Meningitis, Cryptococcal / drug therapy*
  • Meningitis, Cryptococcal / mortality
  • Middle Aged
  • Treatment Outcome

Substances

  • Anti-Retroviral Agents
  • Amphotericin B
  • Fluconazole