Which antifungal medication is primarily used to treat cryptococcal meningitis?

Cryptococcal meningitis is a serious fungal infection, primarily affecting individuals with weakened immune systems, such as those with HIV/AIDS. The treatment of this condition often requires a combination approach to ensure both efficacy and reduction in the risk of treatment failure.

Amphotericin B combined with flucytosine is the preferred regimen for treating cryptococcal meningitis. Amphotericin B is a broad-spectrum antifungal that is effective against the yeast-like fungus Cryptococcus neoformans, the causative agent of cryptococcal meningitis. It works by binding to fungal cell membranes, leading to cell death.

Flucytosine is an antimetabolite that works synergistically with Amphotericin B. It is converted within fungal cells to 5-fluorouracil, which interferes with nucleic acid synthesis, further enhancing the antifungal effect. The combination allows for improved outcomes, reducing the likelihood of resistance development and contributing to a more comprehensive attack on the infection.

Using Amphotericin B alone, while effective, may not be as optimal as the combination therapy due to the potential for increased resistance and the lack of synergistic effects. Other options, such as fluconazole and voriconazole, typically do not