Ketoconazole was used to treat an indolent case of cryptococcal meningitis that had not completely responded to a course of standard therapy with amphotericin B and flucytosine. Despite treatment with 600 mg/day of ketoconazole for seven months and adequate serum and CSF concentrations, the patient suffered a relapse while still receiving the drug. After the relapse, the condition responded to a higher-than-standard dose course of amphotericin B and flucytosine.
Perfect JR, Durack DT, Hamilton JD, Gallis HA. Failure of Ketoconazole in Cryptococcal Meningitis. JAMA. 1982;247(24):3349–3351. doi:10.1001/jama.1982.03320490047035
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