A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptoccal meningitis.

@article{Bennett1979ACO,
  title={A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptoccal meningitis.},
  author={J. Bennett and W. Dismukes and R. Duma and G. Medoff and M. Sande and H. Gallis and J. Leonard and B. T. Fields and M. Bradshaw and H. Haywood and Z. A. McGee and T. Cate and C. Cobbs and J. Warner and D. Alling},
  journal={The New England journal of medicine},
  year={1979},
  volume={301 3},
  pages={
          126-31
        }
}
We compared amphotericin B therapy for cryptococcal meningitis with a newer regimen containing both amphotericin B and flucytosine. In 50 patients with 51 courses of therapy adherent to the protocol, 27 courses were with amphotericin B and 24 with the combination. Even though the combination regimen was given for only six weeks and amphotericin B for 10 weeks, the combination cured or improved more patients (16 vs 11), produced fewer failures or relapses (three vs. 11), more rapid sterilization… Expand
Fluconazole compared with amphotericin B plus flucytosine for cryptococcal meningitis in AIDS. A randomized trial.
TLDR
Amphotericin B used in combination with flucytosine has superior mycologic and clinical efficacy compared with fluconazole for the treatment of cryptococcal meningitis in patients with AIDS. Expand
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The view is that the four-week regimen should be reserved for patients who have meningitis without neurologic complications, underlying disease, or immunosuppressive therapy; a pretreatment cerebrospinal fluid white-cell count above 20 per cubic millimeter and a serum cryptococcal antigen titer below 1:32. Expand
Comparison of amphotericin B with fluconazole in the treatment of acute AIDS-associated cryptococcal meningitis. The NIAID Mycoses Study Group and the AIDS Clinical Trials Group.
TLDR
Fluconazole is an effective alternative to amphotericin B as primary treatment of cryptococcal meningitis in patients with AIDS and single-drug therapy with either drug is most effective in patients who are at low risk for treatment failure. Expand
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Am amphotericin B-induced azotemia was not a significant risk factor for the subsequent development of bone marrow, gastrointestinal, or hepatic toxicity attributable to flucytosine in patients with cryptococcal meningitis. Expand
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TLDR
The addition of ketoconazole to subtherapeutic dose of amphotericin B significantly increased the killing of cryptococci in cerebrospinal fluid. Expand
Comparison of Amphotericin B and its combination with Flucytosine in the Management of Cryptococcal Meningitis: a Review
TLDR
Evidence was found that combining Amphotericin B with Flucytosine had better clinal improvement than AmB monotherapy, and in all studies included FlucyTosine addition resulted better outcomes in cerebrospinal fluid yeast count, serologic evidence, clinical symptoms, survival rate, or occurrence of adverse drug events. Expand
Fluconazole combined with flucytosine for treatment of cryptococcal meningitis in patients with AIDS.
  • R. Larsen, S. Bozzette, +7 authors J. Leedom
  • Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1994
TLDR
In this pilot study of fluconazole combined with flucytosine, the rate of clinical success at 10 weeks was greater than that previously reported with regard to the use of flu Conazole alone or amphotericin B alone. Expand
Amphotericin B versus amphotericin B plus 5-flucytosine: Poor results in the treatment of proven systemic mycoses in neutropenic patients
TLDR
Treatment with both regimens was disappointing partly because mycosis was too far advanced by the time therapy was begun and neutrophils were recovered in only half the patients. Expand
Fluconazole and Amphotericin B for Cryptococcal Meningitis
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A 41-year-old woman with cryptococcal meningitis who was not infected with HIV was treated with a combination of amphotericin B and fluconazole because she did not respond to amphotericIn B alone and could not tolerate amphoteric in B with flucytosine. Expand
Amphotericin B versus amphotericin B plus 5-flucytosine: Poor results in the treatment of proven systemic mycoses in neutropenic patients
Twenty-eight neutropenic (<500 granulocytes/µl) adults with microbiologically or histologically proven systemic mycosis were randomly assigned to receive either amphotericin B alone (0.5 mg/kg/day;Expand
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A shorter period of hospitalization and reduction in toxicity of amphotericin B suggest that combined therapy is a safe and efficacious alternative to other regimens. Expand
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Summary The efficacy of amphotericin B and 5-fluorocytosine used in combination against several different isolates of Cryptococcus neoformans, Candida albicans, Candida tropicalis, and SaccharomycesExpand
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TLDR
In the present report 40 cases of cryptococcal meningitis seen at the National Institutes of Health will be reviewed, particular attention being given to symptoms and cerebrospinal-fluid and cultural findings before treatment and the relation. Expand
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A cylinder plate bioassay for 5-fluorocytosine (5-FC) is described which permits determination of 5- FC concentrations in biological fluids in the presence of amphotericin B, and the effect of renal function on 5-FC concentrations in cerebrospinal fluid was similar to that seen with serum. Expand
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