Evidence map›Paper›PMID 36111370›Full record

ArticleMycoses2023

Induction therapy with high-dose fluconazole plus flucytosine for human immunodeficiency virus-uninfected cryptococcal meningitis patients: Feasible or not?

Hua-Zhen Zhao, Jia-Hui Cheng, Ling-Hong Zhou, Yu Luo, Rong-Sheng Zhu, Ying-Kui Jiang, Xuan Wang, Li-Ping Zhu

Open access · hybridAbstract read
In one paragraph

Article in Mycoses, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Hua-Zhen ZhaoShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Jia-Hui ChengShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Ling-Hong ZhouShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Yu LuoShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Rong-Sheng ZhuShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Ying-Kui JiangShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Xuan WangShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Li-Ping ZhuShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0002-3098-7307
Fudan University · CN

Funding

National Key Research and Development Program of China 2021YFC2300400National Natural Science Foundation of China 81971911Shanghai Municipal Science and Technology Major Project HS2021SHZX001
6 · The paper itself

Abstract

backgroundCryptococcal meningitis (CM) is increasingly recognised in human immunodeficiency virus (HIV)-uninfected patients with high mortality. The efficacy and safety profiles of induction therapy with high-dose fluconazole plus flucytosine remain unclear.

methodsHIV-uninfected CM patients who received high-dose fluconazole (800 mg/d) for initial therapy in Huashan Hospital were included in this retrospective study from January 2013 to December 2018. Efficacy and safety of initial therapy, clinical outcomes and risk factors were evaluated.

resultsTwenty-seven (71.1%) patients who received high-dose fluconazole with flucytosine combination therapy and 11 (28.9%) having fluconazole alone for induction therapy were included. With a median duration of 42 days (IQR, 28-86), the successful response rate of initial therapy was 76.3% (29/38), while adverse drug reactions occurred in 14 patients (36.8%). The rate of persistently positive cerebrospinal fluid (CSF) culture results was 30.6% at 2 weeks, which was significantly associated with CSF CrAg titre >1:1280 (OR 9.56; 95% CI 1.40-103.65; p = .010) and CSF culture of Cryptococcus >3.9 log

conclusionsInduction therapy with high-dose fluconazole (800 mg/d), combined with flucytosine, effectively treated HIV-uninfected CM and was well tolerated. Long-term fluconazole treatment with continued monitoring is beneficial for patients with persistent infection.

Indexed as

HIV InfectionsMeningitis, CryptococcalAntifungal AgentsDrug Therapy, CombinationFluconazoleFlucytosineHIVHumansInduction ChemotherapyRetrospective StudiesAntifungal AgentsFluconazoleFlucytosinecryptococcal meningitisfluconazolehigh doseHIV-uninfectedinduction therapy

Identifiers

PMID36111370
PMCPMC10087831
OpenAlexW4296039597

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.