Initial treatment
a
and outcome
b
|
No of patients/strains
|
No. of strains not susceptible to anti-fungal agent
c
|
---|
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].