摘要Background Amphotericin B (0.7 mg/kg) with flucytosine is the standard treatment for cryptococcal meningitis.However,the long treatment course can induce adverse reactions in patients; therefore,reducing the dose may decrease such reactions.We performed a retrospective analysis of treatment effects and adverse reactions when amphotericin B (0.4 mg/kg or 0.7 mg/kg per day) and flucytosine were used together to treat HIV-negative patients with cryptococcal meningitis.Methods Retrospective analysis was conducted on inpatients at the First Affiliated Hospital,College of Medicine,Zhejiang University (January 2005 to December 2009).Low- or high-dose amphotericin B (0.4 or 0.7 mg/kg per day,respectively) plus flucytosine was used.The negative conversion rate of Cryptococcus in the cerebrospinal fluid (CSF),patient mortality,and the incidence of side effects for the two groups (low- vs.high-dose) were compared immediately after treatment and 2 and 10 weeks later.Data were analyzed by the Student's t test,chi-square tests using SPSS 12.0 statistical soitware.Results Two weeks post-treatment,Cryptococcus negative CSF rates were 78％ (18/23) in the low-dose group and 87％ (13/15) in the high-dose group (P=0.28).Ten weeks post-treatment,both groups were negative.The mortality rate was 8％ (2/25) in the low-dose group and 17％ (3/18) in the high-dose group (P=-0.25).There was a statistically significant difference in the incidence of adverse events between the groups,48％ (12/25) and 78％ (14/18) in the low- and high-dose groups,respectively (P=0.04).Adverse events that required a change in treatment program in the low-dose group were 12％ (3/25) compared to 39％ (7/18) in the high-dose group (P=-0.04).Conclusion Low-dose treatment regimens were better tolerated than high-dose ones.