, Volume 4, Issue 4, pp 197-199
Date: 01 Oct 2010

Fluconazole Therapy for Cryptococcal Meningitis: Are Options Available Where It Is Needed Most—Africa?

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Nussbaum JC, Jackson A, Namarika D, et al.: Combination flucytosine and high-dose fluconazole compared with fluconazole monotherapy for the treatment of cryptococcal meningitis: a randomized trial in Malawi.Clin Infect Dis 2010, 50:345–346.

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Introduction

Cryptococcal meningitis has been reported as the most common cause of meningitis in many areas of sub-Saharan Africa where there is a high prevalence of HIV infection. Cryptococcosis is associated with up to 500,000 deaths per year in sub-Saharan Africa [1]. Though access to antiretroviral therapy (ART) is increasing, because of the limited availability of recommended treatment for cryptococcal meningitis, it continues to be responsible for 10% to 20% of all HIV-related deaths in Africa. Although the combination of amphotericin B and flucytosine is recommended for induction-phase treatment, availability is severely limited in many settings, whereas fluconazole has been widely available through a philanthropic program ...