Cryptococcal Meningitis in Patients with the Acquired Immunodeficiency Syndrome |
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| Authors: | Dr. Caroline S. Zeind Pharm.D. Dr. Kerry O. Cleveland M.D. Dr. Madhavi Menon M.D. Dr. James R. Brown Pharm.D. Dr. David K. Solomon Pharm.D. |
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| Affiliation: | 1. Infectious Disease Consultants, Memphis, Tennessee;2. Department of Internal Medicine, University of Tennessee-Memphis, Memphis, Tennessee;3. Department of Clinical Pharmacy, University of Tennessee-Memphis College of Pharmacy and Veterans Affairs Medical Center, Memphis, Tennessee |
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| Abstract: | 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. |
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