Flucytosine monotherapy for cryptococcosis.
Flucytosine (5-FC) monotherapy for cryptococcosis is not advocated because drug resistance emerges during therapy. Reported documentation of this widely accepted belief is surprisingly scarce. Therefore, we reviewed our experience with 5-FC monotherapy for 27 patients treated between 1968 and 1973. Patients were selected on the basis of criteria associated with good prognosis. In this group, 5-FC monotherapy resulted in cure in eight cases and improvement in two. Overall, response was seen in 10 (43%) of 23 evaluable patients. Therapy failed for 13 patients, including 5 who relapsed, 2 who had partial responses, and 6 without response. Resistance was noted to have developed in isolates from six (50%) of 12 patients for whom therapy failed. Although the 57% failure rate associated with 5-FC alone precludes its use as monotherapy, our study did show that this treatment was well tolerated and that failure was not invariably associated with development of resistance.
Clinical Mycology Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
D R
DR
Hospenthal
J E
JE
Bennett
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D003453:Cryptococcosis / Q000188:drug therapy*; D003455:Cryptococcus neoformans / Q000187:drug effects; D004352:Drug Resistance, Microbial; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000935:Antifungal Agents; D005437:Flucytosine