Bibliographic Info
Recommendation
Recommended in favor
Strong
Certainty of evidence
Moderate
For localized non-meningeal disease, or in patients with isolated serum CrAg positivity (where active cryptococcal meningitis has been excluded). Fluconazole 800 mg/day (or 12 mg/kg/ day if below 19 years) for two weeks, then 400 mg/day (or 6 mg/kg/day up to 400–800 mg/ day if below 19 years) for 8 weeks, and continued maintenance with fluconazole 200 mg/day is recommended. The optimal antifungal regimen in this population remains to be determined
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