Correlation of anti-fungal susceptibility with clinical outcomes in patients with cryptococcal meningitis

BMC Infectious Diseases

Table 4 Susceptibility testing results (CLSI method) for Cryptococcus neoformans isolates from patients, with subsequent clinical outcomes after 10 weeks of antifungal therapy

Initial treatment ^a and outcome ^b	No of patients/strains	No. of strains not susceptible to anti-fungal agent ^c
Initial treatment ^a and outcome ^b	No of patients/strains	AMB	FCZ
AMB + 5FC
Cure
Failure
Death	1		1
AMB + FCZ
Cure	7	1	1
Failure	12	4	5
Death	4		1
AMB alone
Cure	11
Failure	4		3
Death	2	2
FCZ alone
Cure	3	1
Failure	1
Death	1		1

Abbreviations: 5FC flucytosine, AMB amphotericin B, FCZ fluconazole.
^aThe 46 patients were divided into 4 groups based on their initial anti-fungal treatment regimen used during the first 2 weeks. Thereafter, all patients received fluconazole (400–600 mg daily for 8 weeks at least then 200 mg daily).
^bTherapeutic cure was defined as improvement or disappearance of symptoms, negative clinical findings and the cerebro-spinal fluid culture was sterile after 10 weeks of anti-fungal therapy. Therapeutic failure was associated with the persistence of symptoms or cerebro-spinal fluid culture still yielding C. neoformans after 10 weeks of anti-fungal therapy. Death was due to any cause before the end of 10 weeks of anti-fungal therapy.
^cThe interpretative criteria for susceptibility to fluconazole were those published by the CLSI [7]. The criteria for susceptibility to amphotericin B were those proposed by Nguyen and Yu [15].

ISSN: 1471-2334