Bibliographic Info
Recommendation
Recommended in favor
Strong
Certainty of evidence
High
For the consolidation phase treatment of HIV infected adults, adolescents and children with cryptococcal meningitis or disseminated non-meningeal disease, the following 8-week antifungal regimen is recommended: Fluconazole 400–800mg/day after a two-week induction with amphotericin B regimen (6–12 mg/kg/day up to 400–800 mg/day if below 19 years). Fluconazole 800 mg/day after induction treatment with short-course amphotericin B or fluconazole-based induction regimen (fluconazole 12 mg/kg/day up to 800 mg/day if below 19 years)
Notes and Remarks
In developing these recommendations, the Guideline Development Group placed high value on balancing the need for the best anti-fungal regimens to achieve optimal survival, neurological outcome, and fungal clearance, while minimizing drug related toxicities. The Guideline Development Group was concerned by the high incidence of serious amphotericin B-related toxicities, particularly hypokalaemia and nephrotoxicity, and the need to ensure its administration is always linked to a simple package of measures to prevent, monitor and manage these toxicities.
Also Featured In
This recommendation also appears in the following guidelines:
Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach