Therapy | ||
Initial therapy | Step-down therapy | Comments |
Liposomal amphotericin B 5 mg/kg IV daily with or without flucytosine* 25 mg/kg orally four times daily for several weeks, followed by step-down therapy with fluconazole once the patient has responded to initial therapy. | Fluconazole 400 to 800 mg (6 to 12 mg/kg) orally¶ daily. | Treat until all signs and symptoms, cerebrospinal fluid abnormalities, and radiographic abnormalities have resolved. Removal of intraventricular devices and other CNS devices is recommended. |
CNS: central nervous system; IV: intravenously.
* Toxic effects on bone marrow and liver require careful monitoring, preferably with frequent serum flucytosine levels.
¶ Since fluconazole is highly bioavailable, oral therapy is appropriate for most patients. Intravenous therapy (at the same dose) should be given to patients who are unable to take oral medications, who are not expected to have good gastrointestinal absorption, or who are severely ill.Do you want to add Medilib to your home screen?