IDSA Recommendations for Preventing and Treating Cryptococcosis in HIV-AIDS

Treatment for cryptococcosis consists of 3 phases: induction, consolidation, and maintenance therapy

Induction Therapy (For At Least 2 Weeks, Followed by Consolidation Therapy) - Preferred Regimens:

 • Liposomal amphotericin B 3–4 mg/kg IV daily plus flucytosine 25 mg/kg PO QID (AI); or

 • Amphotericin B deoxycholate 0.7–1.0 mg/kg IV daily plus flucytosine 25 mg/kg PO QID (AI)—if cost is an issue and the risk of renal dysfunction is low

Consolidation Therapy (For At Least 8 Weeks, Followed by Maintenance Therapy)

 • To begin after at least 2 weeks of successful induction therapy (defined as substantial clinical improvement and a negative CSF culture after repeat LP)

Preferred Regimen:

 • Fluconazole 400 mg PO or IV once daily

Maintenance Therapy - Preferred Regimen:

 • Fluconazole 200 mg PO for at least 1 year (AI)—see below for recommendation of when to stop maintenance therapy



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