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l Meningoencephalitis Non-HIV-Infected and Nontransplant Patients Induction Therapy AmBd (0.7-0.1 mg/kg per day) plus flucytosine (100 mg/kg per day) Duration: ≥ 4 weekse, f (B-II) AmBd OR (0.7-1.0 mg/kg per day)g Duration: ≥ 6 weekse, f (B-II) Liposomal AmB OR (3-4 mg/kg per day) or ABLC (5 mg/kg per day) combined with flucytosine, if possibleh Duration: ≥ 4 weekse, f (B-III) OR AmBd (0.7 mg/kg per day) plus flucytosine (100 mg/kg per day)i Duration: 2 weeks (B-III) Consolidation Fluconazole (400-800 mg per day)j Duration: 8 weeks (B-III) Maintenance Fluconazole (200 mg per day)f Duration: 6-12 months (B-III) Fluconazole (200 mg per day) Duration: 6-12 months (B-III) a Begin HAART 2-10 weeks aſter the start of initial antifungal treatment. b In unique clinical situations in which primary recommendations are not c With successful introduction of HAART, a CD4 cell count ≥ 100 cells/ mL, and low or nondetectable viral load for ≥ 3 months with minimum of 1 year of antifungal therapy. available, consideration of alternative regimens may be made—but not encouraged—as substitutes. See full guidelines for dosages. d Inferior to the primary recommendation. e Four weeks are reserved for patients with meningitis who have no f Fluconazole is given at 200 mg per day to prevent relapse aſter induction therapy, and consolidation therapy is recommended. j A higher dosage of fluconazole (800 mg per day) is recommended if the 2-week induction regimen was used and if there is normal renal function. k Immunosuppressive management may require sequential or step-wise reductions. l Many transplant recipients have been successfully treated with AmBd. However, issues of renal dysfunction with calcineurin inhibitors are important, and the effective dose is imprecise. 5 as an early diagnosis by history, no uncontrolled underlying condition or severe immunocompromised state, and an excellent clinical response to initial 2-week antifungal combination course. neurological complications, who have no significant underlying diseases or immunosuppression, and for whom the cerebrospinal fluid culture performed at the end of 2 weeks of treatment does not yield viable yeasts. During the second 2 weeks, LFAmB may be substituted for AmBd. g For flucytosine-intolerant patients. h For AmBd-intolerant patients. i For patients who have a low risk of therapeutic failure. Low risk is defined Maintenance Consolidation Fluconazole (400-800 mg per day) Duration: 8 weeks (B-III) Transplant Recipientsk Induction Therapy Liposomal AmB (3-4 mg/kg per day) plus flucytosine (100 mg/kg per day) Duration: 2 weeks (B-III) Alternatives to Induction Therapy Liposomal AmB (6 mg/kg per day) or ABLC (5 mg/kg per day) Duration: 4-6 weeks (B-III) OR AmBd (0.7 mg/kg per day)l Duration 4-6 weeks (B-III)