Flucytosine in Solid Organ Transplantation (SOT)

Flucytosine in Solid Organ Transplantation (SOT)

Cryptococcosis is the third most commonly occurring invasive fungal infection in SOT recipients. Cryptococcosis represents 8% of invasive fungal infections in SOT recipients in the Transplant Associated Infection Surveillance Network database.

For the management of meningoencephalitis or disseminated cryptococcosis, induction therapy with liposomal amphotericin B (3–4 mg/kg per day) or amphotericin B lipid complex (5 mg/kg per day) plus flucytosine (100 mg/kg per day) for 14 days, followed by a consolidation phase with fluconazole (400–800 mg per day) for 8 weeks and, finally, maintenance or suppression therapy with fluconazole (200–400 mg per day) for 6–12 months (provided the immunosuppression is not augmented) has been recommended before in published literature.