Trial reportMycoses2019
Short-course amphotericin B in addition to sertraline and fluconazole for treatment of HIV-associated cryptococcal meningitis in rural Tanzania.
Trial report in Mycoses, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- HIV-Associated Cryptococcal Meningitis: A Call for Action for New Treatment Options.Therapeutics · 2026Article
- Assessing Statistical Methods for Estimating the Cerebrospinal Fluid Early Fungicidal Activity as an Endpoint for Cryptococcal Meningitis Clinical Trials: A Systematic Review and Simulation Study.Open forum infectious diseases · 2026Article
- A review of the current anti-New microbes and new infections · 2026Review
- Therapeutic Repurposing of Sertraline: Evidence for Its Antifungal Activity from In Vitro, In Vivo, and Clinical Studies.Microorganisms · 2025Review
- Antifungal and antibiofilm effect of duloxetine hydrochloride against Cryptococcus neoformans and Cryptococcus gattii.Folia microbiologica · 2024Article
- Lived experience of people with cryptococcal meningitis: A qualitative study.Southern African journal of HIV medicine · 2024Article
- Article
- Article
- The Chronic Diseases Clinic of Ifakara (CDCI)-Establishing a Model Clinic for Chronic Care Delivery in Rural Sub-Saharan Africa.Diseases (Basel, Switzerland) · 2022Article
- Synergism between the Antidepressant Sertraline and Caspofungin as an Approach to Minimise the Virulence and Resistance in the DermatophyteJournal of fungi (Basel, Switzerland) · 2022Article
- Causes of death and associated factors over a decade of follow-up in a cohort of people living with HIV in rural Tanzania.BMC infectious diseases · 2022Article
- Is Ferroptosis a Future Direction in Exploring Cryptococcal Meningitis?Frontiers in immunology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 5 countries.
Funding
Abstract
backgroundCryptococcal meningitis accounts for 15% of all AIDS mortality globally. Most cases in low- and middle-income countries are treated with fluconazole monotherapy, which is associated with a high mortality. New available therapies are needed. Short-course amphotericin B has been shown to be a safe and efficient therapeutic option. Sertraline has in vitro fungicidal activity against Cryptococcus and bi-directional synergy with fluconazole.
methodsWe conducted an open-label clinical trial to assess the safety and efficacy of sertraline 400 mg/day and fluconazole 1200 mg/day (n = 28) vs sertraline, fluconazole and additional 5 days of amphotericin B deoxycholate 0.7-1 mg/kg (n = 18) for cryptococcal meningitis.
resultsTwo-week survival was 64% (18/28) without amphotericin and 89% (16/18) with amphotericin, and 10-week survival was 21% (6/28) vs 61% (11/18), respectively (P = .012). The cerebrospinal fluid (CSF) Cryptococcus clearance rate was 0.264 log
conclusionsShort-course amphotericin substantially increased CSF clearance and 10-week survival. Adjunctive sertraline improved 2-week CSF fungal clearance but did not improve 10-week mortality compared with published data using fluconazole 1200 mg/day monotherapy (early fungicidal activity 0.15 log
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Registered trials
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