title: Combination Versus Monotherapy for the Treatment of HIV Associated Cryptococcal Meningitis.
abstract: OBJECTIVE
  To study the efficacy of anti Cryptococcal treatment by cerebrospinal fluid (CSF) fungal negativity after two weeks of treatment with amphotericin B alone or combined with fluconazole in treatment of HIV associated Cryptococcal meningitis (CM).
  
  
  METHODS
  A total of 84 human immunodeficiency virus (HIV) associated CM patients confirmed by CSF culture positivity were recruited for the study. Patients were randomly divided into two groups. Group A was given amphotericin B alone whereas Amphotericin B in combination with fluconazole was given in group B for the treatment of CM. Patients were followed for 14 days.
  
  
  RESULTS
  Maximum number of patients was in the age group 21-49 y. All the 84 patients had <100 CD4 counts/μl. After 14 days of the treatment in group A and B, there was no significant difference in terms of fever, headache and neck stiffness as a clinical outcome. But in group B there was improved in altered sensorium and focal neurological deficit as compared to group A. After 14 days of the treatment CSF culture negativity was more in group B as compared to group A.
  
  
  CONCLUSIONS
  Amphotericin B in combination with fluconazole is recommended for the treatment of HIV associated CM.
authors: Associate Professor, Department of Medicine, Sri Aurobindo Medical College and PG Insitute , Indore, India .
authors: Shashank Anant
authors: SA
authors: Vaidhya
authors: Associate Professor, Department of Medicine, Sri Aurobindo Medical College and PG Insitute , Indore, India .
authors: Bharat Bhushan
authors: BB
authors: Gupta
authors: Professor and Head, Department of Medicine, Sri Aurobindo Medical College and PG Insitute , Indore, India .
authors: Rajesh Kumar
authors: RK
authors: Jha
authors: Scientist, Central Research Laboratory, Sri Aurobindo Medical College and PG Insitute , Indore, India .
authors: Ravindra
authors: R
authors: Kumar
keywords: Amphotericin B; Combination therapy; Cryptococcal Meningitis; Fluconazole; HIV