Antifungal choice for cryptococcus! - USMLE Forums
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Old 08-30-2011
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Drug Antifungal choice for cryptococcus!

Goljan audio says that we treat cryptococcus and histoplasma by actinomycen...but in his book it says fluconazole..and in the notes it says amphotericn b?? and this was a previous exam q according to dr goljan...so what is the correct one?
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Old 08-30-2011
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If you continue listening to Dr. Goljan, he will later correct himself saying its Amphotericin B
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Old 08-30-2011
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thanx a lot
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Old 08-30-2011
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Depends, Amphotericin doesnt cross the Blood-brain barrier, if you inject Amphotericin directly "Intrathecally" then yes, is the choice here. Also Flucytosine is use in "conjuction" with Amphotericin...


If you want to give something that can cross the BBB, then you can use Fluconazole for Cryptococcus on AIDS patient. it can cross it.
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Old 08-30-2011
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Amphotericin B is drug of choice for most of the systemic infections like cryptococcus,candidiasis,histoplasmosis etc.But it does not cross BBB unless given Intrathecally .The major problem with it is haematotoxicity so to prevent that its usually given with Flucytosine and has synergistic affect.
It is given prophylatically to prevent cryptococcal meningitis but DOC is Amphotericin B.
Hope this helps
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Old 08-30-2011
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I meant Flucytosine is given prophylactically but Amphotericin B is DOC.
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Old 09-16-2011
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fluconazol cross BBB, so it's ideal Rx for cryptococcus
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