Cryptococcosis with AIDS: therapeutic strategies

Abstract

Cryptococcosis is the most common life-threatening mycosis with AIDS. The combination therapy based on amphotericin B and flucytosine is furthermore the therapy of first choice, even after introduction of fluconazole. With a therapy maintained over a period of 6 weeks the combination is nearly always successful; a shorter treatment period leads to minor treatment success. Since no elimination of the pathogen is possible in cryptococcosis with AIDS a permanent relapse prevention is necessary. In this prevention strategy fluconazole is highly effective and at present the drug of first choice; it is as effective as amphotericin B. An additional advantage is the possibility of oral application.

The past, present and future of antimycotic combination therapy

“…Thus, based on these important clinical studies, the combination of Amph B+5FC is again established as initial therapy for cryptococcal meningitis in AIDS patients and is world‐wide successfully practised (Table 5) [54, 56, 58–66].…”