JAMA Netw Open

Single-dose liposomal amphotericin shows promise for cryptococcal meningitis in U.S. safety‑net setting

January 26, 2026

In a pre–post cohort study at a U.S. public hospital, investigators compared traditional multi-day liposomal amphotericin B–based induction with the AMBITION protocol (single-dose liposomal amphotericin B plus 2 weeks of fluconazole and flucytosine). Treatment success at 90 days (survival without recurrence or severe adverse events) was significantly higher with the single-dose regimen (76% vs. 35%; P = 0.006), driven by fewer severe toxic effects. Mortality and recurrence rates were similar between groups. A reduction in patient-directed discharges suggested a shift toward more patient-centered care.

Clinical takeaway: A single high-dose liposomal amphotericin B induction strategy may reduce toxicity and improve overall treatment success for HIV-associated cryptococcal meningitis in high-resource settings, supporting broader adoption where feasible.

Source:

Clark D, et al. (2026, January 21). JAMA Netw Open. Single-Dose Liposomal Amphotericin Plus Fluconazole and Flucytosine for Cryptococcal Meningitis at a US Public Hospital. https://pubmed.ncbi.nlm.nih.gov/41563759/