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Treatment of Fungal Infections-Reply

James A. Krick, MD; Jack S. Remington, MD
Arch Intern Med. 1975;135(9):1271. doi:10.1001/archinte.1975.00330090143023.
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In regard to Harder and Hermans' comments on our editorial "Treatment of Fungal Infections," we would like to make the following comments (according to the paragraphs of their letter):

Paragraph 3.  —First, our editorial emphasis was on evaluating the results of treatment of fungal infections with flucytosine, primarily alone but also in combination with amphotericin B. In examining the published cases, we frequently found it impossible to understand what role flucytosine played in any patient who also received amphotericin B. Second, amphotericin B probably should not be considered to have failed in the treatment of cryptococcal meningitis until an intrathecal course of the drug has been given.

Paragraph 4.  —First, due to the tendency of cryptococcal meningitis to relapse after treatment (as we emphasized in our editorial), we are at a loss to interpret the results of treatment in any patient for whom the duration of follow-up is not indicated.


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