{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T04:14:00Z","timestamp":1768709640856,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,6,9]],"date-time":"2019-06-09T00:00:00Z","timestamp":1560038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Cryptococcal meningitis (<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>) carries a high risk of mortality with increasing incidences in immune competent hosts. Current treatments are not well tolerated, and evaluation of other treatments is needed. Fluconazole and 5\u2010flucytosine in treating immune competent hosts have not been characterised. To evaluate the efficacy of fluconazole and 5\u2010flucytosine in treating non\u2010<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010 and non\u2010transplant\u2010associated <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>. We performed a retrospective cohort study of the outcomes in immune competent patients with <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> treated with fluconazole and 5\u2010flucytosine or deoxycholate\u2010amphotericin B and 5\u2010flucytosine. The primary outcome was treatment response evaluated at the 12th week after initiation of antifungal therapy. A total of 43 and 47 patients received amphotericin B deoxycholate and 5\u2010flucytosine or fluconazole and 5\u2010flucytosine, respectively. A total of 38 (88.4%) patients cannot tolerate recommended doses of amphotericin B deoxycholate and 5\u2010flucytosine (patients needed dose reduction during the treatment). Patients given fluconazole and 5\u2010flucytosine had higher baseline cryptococcal burdens (median 3632 versus 900 cryptococci\/mL, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). No significant differences were seen in cryptococcus clearance (74.4% vs 70.2%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.814), treatment time (39\u00a0days, 20\u201069\u00a0days vs 21\u00a0days, 7\u201063\u00a0days, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.107) and successful response (including complete and partial responses) rates (69.7% vs 72.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.820). Fluconazole and 5\u2010flucytosine treatment had lower total adverse events (19.1% vs 90.7%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Fluconazole and 5\u2010flucytosine had relatively high efficacy with few adverse events in treating <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>. Fluconazole and 5\u2010flucytosine therapy is promising in patients that do not tolerate or are not suited for amphotericin B deoxycholate treatment.<\/jats:p>","DOI":"10.1111\/myc.12944","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T17:59:20Z","timestamp":1558634360000},"page":"686-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Fluconazole plus flucytosine is a good alternative therapy for non\u2010<scp>HIV<\/scp> and non\u2010transplant\u2010associated cryptococcal meningitis: A retrospective cohort study"],"prefix":"10.1111","volume":"62","author":[{"given":"Zhanyi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou 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