Induction Therapy (≥2 Weeks or Until Clinically Improved)

   Preferred Therapy

• Liposomal amphotericin B: 3 mg/kg IV daily (AI)

   Alternative Therapy:

• Amphotericin B lipid complex: 5 mg/kg IV daily (AIII)

Maintenance Therapy (≥12 months and Until Resolution of Abnormal CSF Findings)

   Preferred Therapy

• Itraconazole: 200 mg PO three times a day for 3 days, then 200 mg PO two times a day (AII)

   Alternative Therapy
    Note: these recommendations are based on limited clinical data for people who are intolerant to itraconazole and only moderately ill. 

• Posaconazole: 300 mg extended-release tablet PO twice daily for 1 day, then 300 mg PO once daily (BIII), or
• Voriconazole: 400 mg PO twice daily for 1 day, then 200 mg PO twice daily (BIII), or
• Fluconazole: 800 mg PO once daily (Cll)

Induction and Maintenance Therapy

   Preferred Therapy

• Itraconazole: 200 mg PO three times a day for 3 days, then 200 mg PO two times a day (AII)

   Alternative Therapy

• Posaconazole: 300 mg extended release tablet PO twice a day for 1 day, then 300 mg PO once a day (BIII), or
• Voriconazole: 400 mg PO twice a day for 1 day, then 200 mg PO twice a day (BIII), or
• Fluconazole: 800 mg PO once a day (CII)

Induction Therapy (4–6 weeks Depending on Symptom Resolution and Improvement of CSF Findings)

   Preferred Therapy

• Liposomal amphotericin B: 5 mg/kg IV daily (AIII)

   Alternative Therapy

• Amphotericin B deoxycholate: 0.7-1.0 mg/kg IV daily (BIII)

Maintenance Therapy (≥12 Months and Until Resolution of Abnormal CSF Findings)

   Preferred Therapy

• Itraconazole: 200 mg PO two or three times a day (AIII)

   Alternative Therapy 
   Note: These recommendations are based on limited clinical data for patients intolerant to itraconazole.

• Voriconazole: 400 mg PO twice a day for 1 day, then 200 mg PO twice a day (BIII), or
• Fluconazole: 800 mg PO once a day (CII); for people who cannot tolerate both itraconazole and voriconazole