Fluconazole and amphotericin B for cryptococcal meningitis

Amy B. Clark, Bob L. Lobo, Michael Gelfand

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To describe a patient with cryptococcal meningitis treated with the combination of amphotericin B and fluconazole. CASE SUMMARY: A 41- year-old woman with cryptococcal meningitis who was not infected with HIV was treated with a combination of amphotericin B and fluconazole because she did not respond to amphotericin B alone and could not tolerate amphotericin B with flucytosine. She improved clinically, but it is unclear whether the combination was beneficial. DISCUSSION: Standard therapy for cryptococcal meningitis is amphotericin B with or without flucytosine. Fluconazole is an alternative therapy, but its efficacy has not been documented in the patient population not infected with HIV. Theoretically, the combination of amphotericin B and fluconazole is antagonistic, but in vitro and in vivo data suggest that antagonism may not occur. The combination of amphotericin B and fluconazole in cryptococcal meningitis has not been evaluated in clinical trials, and its use is not recommended. CONCLUSIONS: A patient with cryptococcal meningitis was treated with the combination of amphotericin B and fluconazole because of a poor response to amphotericin B monotherapy and intolerance to flucytosine. It is unclear whether her clinical response was a result of the combination.

Original languageEnglish (US)
Pages (from-to)1408-1410
Number of pages3
JournalAnnals of Pharmacotherapy
Volume30
Issue number12
DOIs
StatePublished - Jan 1 1996

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Cryptococcal Meningitis
Fluconazole
Amphotericin B
Flucytosine
HIV
Complementary Therapies
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Fluconazole and amphotericin B for cryptococcal meningitis. / Clark, Amy B.; Lobo, Bob L.; Gelfand, Michael.

In: Annals of Pharmacotherapy, Vol. 30, No. 12, 01.01.1996, p. 1408-1410.

Research output: Contribution to journalArticle

Clark, Amy B. ; Lobo, Bob L. ; Gelfand, Michael. / Fluconazole and amphotericin B for cryptococcal meningitis. In: Annals of Pharmacotherapy. 1996 ; Vol. 30, No. 12. pp. 1408-1410.
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