Recommendations
| Dosage | Remarks | |
|---|---|---|
|
liposomal amphotericin B (Ambisome) IV 3 mg/kg once daily
+ flucytosine IV 25 mg/kg four times daily |
meningitis, brain abscess |
|
|
fluconazole IV loading dose 800 mg, then 400 mg once daily for 6 weeks
|
Step-down with clinical improvement, possibly oral. |
If a VPD is in situ remove the drain and place an EVD. Internalise 10 days after the first negative culture.
Flucytosine is contraindicated in patients with dihydropyrimidine dehydrogenase (DPD) deficiency. However, pre-testing is not necessary given the rarity of this deficiency.