Evidence map›Paper›PMID 38143852›Full record

ArticleOpen forum infectious diseases2023

5-Flucytosine Longitudinal Antifungal Susceptibility Testing of

Thomas C McHale, Andrew Akampurira, Elliot S Gerlach, Atukunda Mucunguzi, Melanie R Nicol, Darlisha A Williams, Kirsten Nielsen, Tihana Bicanic, Ann Fieberg, Biyue Dai and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Evaluating the Use of Lower Dose Flucytosine for the Treatment of Cryptococcal Meningitis: A Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Trial
  2. Review
  3. RapidmSphere · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 4 countries.

Thomas C McHaleDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-7226-3075
Andrew AkampuriraInfectious Diseases Institute, Makerere University, Kampala, Uganda.
Elliot S GerlachDepartment of Microbiology & Immunology, University of Minnesota, Minneapolis, Minnesota, USA.
Atukunda MucunguziInfectious Diseases Institute, Makerere University, Kampala, Uganda.
Melanie R NicolDepartment of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0001-5513-5509
Darlisha A WilliamsDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Kirsten NielsenDepartment of Microbiology & Immunology, University of Minnesota, Minneapolis, Minnesota, USA.
Tihana BicanicInstitute of Infection and Immunity, St Georges, University of London, London, UK.ORCID https://orcid.org/0000-0002-2676-838X
Ann FiebergDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Biyue DaiDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
David B MeyaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-8854-0321
David R BoulwareDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
ENACT Trial Team
University of Minnesota · USInfectious Diseases Institute · UGSt George's, University of London · GB

Funding

Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related MeningitisR01NS086312 · NINDS · UNIVERSITY OF MINNESOTA · PI David R Boulware, David Bisagaya Meya · 2013 to 2026
$8.3M
Infectious Disease Training in Clinical InvestigationT32AI055433 · NIAID · UNIVERSITY OF MINNESOTA TWIN CITIES · PI David R Boulware · 2003 to 2026
$6.1M
Genomic Research Capacity Building for Cryptococcosis Translational StudiesR01NS118538 · NINDS · VIRGINIA POLYTECHNIC INST AND ST UNIV · PI Joel Bazira, David Bisagaya Meya · 2020 to 2026
$3.4M
Encochleated Oral Amphotericin for Cryptococcal Meningitis TrialR01NS110519 · NINDS · UNIVERSITY OF MINNESOTA · PI BOULWARE, DAVID R, MEYA, DAVID BISAGAYA · 2019 to 2022
$2.6M
Encochleated Oral Amphotericin for HIV-related Cryptococcal Meningitis Trial: Phase 3 TrialUG3NS131096 · NINDS · UNIVERSITY OF MINNESOTA · PI BOULWARE, DAVID R, MEYA, DAVID BISAGAYA · 2023 to 2023
$2.1M
NIAID NIH HHS T32 AI055433NINDS NIH HHS R01 NS086312NINDS NIH HHS R01 NS110519NINDS NIH HHS R01 NS118538NINDS NIH HHS UG3 NS131096
6 · The paper itself

Abstract

Background: The EnACT trial was a phase 2 randomized clinical trial conducted in Uganda, which evaluated a novel orally delivered lipid nanocrystal (LNC) amphotericin B in combination with flucytosine for the treatment of cryptococcal meningitis. When flucytosine (5FC) is used as monotherapy in cryptococcosis, 5FC can induce resistant Methods: We enrolled Ugandans with HIV diagnosed with cryptococcal meningitis and who were randomized to receive 5FC and either standard intravenous (IV) amphotericin B or oral LNC-amphotericin B. We used broth microdilution to measure the minimum inhibitory concentration (MIC) of the first and last cryptococcal isolates in each participant. Breakpoints are inferred from 5FC in Results: Conclusions: There is no evidence of baseline resistance to 5FC or incident resistance during combination therapy with oral or IV amphotericin B in Uganda. Oral amphotericin B can safely be used in combination with 5FC.

Indexed as

5-flucytosine resistanceantifungal resistanceantifungal susceptibility testingcryptococcal meningitis

Identifiers

PMID38143852
PMCPMC10745249
OpenAlexW4389116858

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.