Cryptococcus (IDSA 2010)

Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update

Meningoencephalitis

HIV-infected

• Induction: AmBd 0.7-1 mg/kg/d IV plus flucytosine 100 mg/kg/d po split QID for at least 2 weeks
  • Can use liposomal AmB 3–4 mg/kg/d IV or ABLC 5 mg/kg/d IV
  • Can continue for 4-6 weeks if high fungal burden or failure to respond
  • Can replace flucytosine with fluconazole 800-1200 mg daily for minimum of 8 weeks if needed
• Consolidation: fluconazole 400 mg daily for at least 8 weeks
  • If high