Cryptococcal meningitis in patients with the acquired immunodeficiency syndrome.
The optimum therapy for cryptococcal meningitis in patients with the acquired immunodeficiency syndrome (AIDS) remains unresolved. Traditional therapy consists of amphotericin B with or without flucytosine. Obstacles exist in administering these agents to patients with AIDS. Mortality rates during initial therapy are relatively high. Given the lack of proved benefit, we do not recommend adding flucytosine to amphotericin B routinely. The search for more efficacious and less toxic agents continues. The oral triazoles, especially fluconazole, have increased the options for treatment of this disease. New strategies and novel approaches in managing cryptococcal meningitis in patients with AIDS continue to be developed.
Zeind
C S
CS
Department of Clinical Pharmacy, Massachusetts College of Pharmacy and Allied Health Sciences, Boston 02115-5896, USA.
Cleveland
K O
KO
Menon
M
M
Brown
J R
JR
Solomon
D K
DK
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000627:therapeutic use*; D006678:HIV; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole