A randomized controlled trial for the treatment of HIV-associated cryptococcal meningitis in Africa: oral fluconazole plus flucytosine or one week amphotericin-based …
S Molloy, C Kanyama, R Heyderman… - Journal of the …, 2017 - openaccess.sgul.ac.uk
S Molloy, C Kanyama, R Heyderman, A Loyse, C Kouanfack, D Chanda, S Mfinanga…
Journal of the International AIDS Society, 2017•openaccess.sgul.ac.ukBackground: Cryptococcal meningitis (CM) accounts for 10–20% of HIV-related deaths and>
100,000 deaths/year. Amphotericin (AmB) plus flucytosine for 2 weeks is considered the
gold standard but is unavailable in resource-limited settings where fluconazole treatment
predominates. Methods: Based on Phase II studies, we tested, against 2 weeks AmB-based
treatment, 2 new strategies, which could be sustainable in Africa, and more effective than
fluconazole: optimized oral therapy of high dose fluconazole plus flucytosine, and short (1 …
100,000 deaths/year. Amphotericin (AmB) plus flucytosine for 2 weeks is considered the
gold standard but is unavailable in resource-limited settings where fluconazole treatment
predominates. Methods: Based on Phase II studies, we tested, against 2 weeks AmB-based
treatment, 2 new strategies, which could be sustainable in Africa, and more effective than
fluconazole: optimized oral therapy of high dose fluconazole plus flucytosine, and short (1 …
Background: Cryptococcal meningitis (CM) accounts for 10–20% of HIV-related deaths and> 100,000 deaths/year. Amphotericin (AmB) plus flucytosine for 2 weeks is considered the gold standard but is unavailable in resource-limited settings where fluconazole treatment predominates.
Methods: Based on Phase II studies, we tested, against 2 weeks AmB-based treatment, 2 new strategies, which could be sustainable in Africa, and more effective than fluconazole: optimized oral therapy of high dose fluconazole plus flucytosine, and short (1 week) induction with AmB-based treatment. In the AmB arms, we compared fluconazole and flucytosine as adjunctive treatments. Between 2013 and 2016, 721 participants from 9 centres in Malawi, Zambia, Cameroon and Tanzania with first-episode CM were randomized to:
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