Comparison of Amphotericin B,Fluconazole,and Combined Treatments in Adult HIV-negative Cryptococcal Meningitis

During 1986-2001, a total of 101 HIV-negative cryptococcal meningitis patients, including 60 males and 41 females, aged 15-83 years, were included in this study. According to different antifungal treatment regimens, the 101 patients were divided into three groups, which were the weeks were determined using a modified Barthel index (BI). For the purpose of statistical analysis, amphotericin B group, fluconazole group, and combination group. Therapeutic outcomes at 10 weeks were determined using a modified Barthel index (BI). For the purpose of statistical analysis, the patients were divided into two groups: good outcome (BI ~ 12) and poor outcome (BI ＜ 12). From a statistical point of view, there was no statistical difference found in the influence of prognosis among the 3 different antifungal regimens. However, did require 35 % fewer numbers of days of hospitalization in patients receiving antifungal regimens containing fluconazole. Although the treatment of HIV-negative cryptococcal meningitis has not been well defined as yet. Regarding the drug adverse effects, relapse rates and the duration of hospitalization days, combined amphotericin B and fluconazole may be one of the best choices in treating this special group of patients. Therefore, early diagnosis, early use of appropriate antifungal treatment, and correction of the underlying metabolic derangement are mandatory needed to improve the treatment of HIV-negative cryptococcal meningitis.