flucytosine + liposomal amphotericin B

Flucytosine + liposomal amphotericin B is a combination antifungal therapy used primarily for the treatment of severe fungal infections, most notably cryptococcal meningitis, especially in people with advanced HIV. Flucytosine is a pyrimidine analog that inhibits fungal DNA and RNA synthesis by conversion to 5-fluorouracil within susceptible fungi. Liposomal amphotericin B is a lipid-based formulation of amphotericin B, which binds to ergosterol in the fungal cell membrane, forming pores that disrupt membrane integrity and cause cell death. The liposomal formulation improves tissue penetration and reduces toxicity compared to conventional amphotericin B. This combination has demonstrated additive or synergistic effects against Cryptococcus neoformans and other pathogenic fungi, leading to more rapid clearance of infection from cerebrospinal fluid and improved survival rates compared to monotherapy[1][2][3][4][5]. It is recommended as first-line induction therapy for cryptococcal meningitis by the World Health Organization[8].