Bibliographic information
Recommendation
For the induction phase of treatment in HIV-infected adults, adolescents and children with cryptococcal disease (meningeal and disseminated non-meningeal), the following two-week antifungal regimens are recommended in order of preference: c. Amphotericin B short course (5–7 days) + high dose fluconazole (to complete 2 weeks of induction) when a minimum package of pre-emptive hydration and electrolyte replacement and toxicity monitoring and management cannot be provided for the full 2-week induction period
Recommended in favor
Conditional
Certainty of evidence
Low
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