Bibliographic information
Recommendation
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)
Recommended in favor
Strong
Certainty of evidence
High
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