Question:medium
Which of the following is the treatment of choice for cryptococcal meningitis?
Which of the following is the treatment of choice for cryptococcal meningitis?
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Cryptococcal meningitis needs a fast fungicidal drug first; amphotericin B is that drug, usually combined with flucytosine, then followed by fluconazole.
Updated On: Jul 8, 2026
- Fluconazole
- Itraconazole
- Flucytosine
- Amphotericin B
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Picture the disease.
Cryptococcal meningitis is a fungal brain infection that spreads fast in people with poor immunity, so the first drug picked has to kill the fungus quickly, not just slow it down.
Step 2: Sort the drugs by how they act.
Amphotericin B is fungicidal, it kills the organism outright by damaging its cell membrane. Fluconazole and itraconazole are mostly fungistatic at usual doses, they stop growth but act slower. Flucytosine works but resistance develops fast if used alone.
Step 3: Match the drug to the urgency.
Because cryptococcal meningitis can be fatal within days, guidelines call for starting Amphotericin B, paired with flucytosine for the first two weeks, as induction therapy, then stepping down to fluconazole for consolidation and maintenance once the patient stabilizes.
Step 4: Rule out the rest.
Itraconazole has poor penetration into the brain and is not used here. Fluconazole alone and flucytosine alone are both too weak or too resistance prone to be first line by themselves.
Step 5: Settle on the answer.
The induction drug that treats this infection is Amphotericin B.
\[ \boxed{\text{Amphotericin B}} \]
Cryptococcal meningitis is a fungal brain infection that spreads fast in people with poor immunity, so the first drug picked has to kill the fungus quickly, not just slow it down.
Step 2: Sort the drugs by how they act.
Amphotericin B is fungicidal, it kills the organism outright by damaging its cell membrane. Fluconazole and itraconazole are mostly fungistatic at usual doses, they stop growth but act slower. Flucytosine works but resistance develops fast if used alone.
Step 3: Match the drug to the urgency.
Because cryptococcal meningitis can be fatal within days, guidelines call for starting Amphotericin B, paired with flucytosine for the first two weeks, as induction therapy, then stepping down to fluconazole for consolidation and maintenance once the patient stabilizes.
Step 4: Rule out the rest.
Itraconazole has poor penetration into the brain and is not used here. Fluconazole alone and flucytosine alone are both too weak or too resistance prone to be first line by themselves.
Step 5: Settle on the answer.
The induction drug that treats this infection is Amphotericin B.
\[ \boxed{\text{Amphotericin B}} \]
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