Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Hopes that tamoxifen could improve survival for a deadly form of fungal meningitis have been dashed by the results of a clinical trial conducted by University of Oxford researchers and published today in eLife.

Typical spherical to oval cells of Cryptococcus neoformans, with extensive capsules and a budding daughter cell © Phan Hai Trieu

The study finds that adding tamoxifen to standard antifungal treatment was no better at speeding up the clearance of fungal infection from the spinal fluid of people with meningitis. More patients who received tamoxifen had evidence of conduction disturbances in their hearts, although there was no difference in the rates of severe side effects between study groups. 

Cryptococcal meningitis is a leading cause of death in people with HIV, but also affects those without HIV, regardless of whether they are immunocompromised. Most infections are caused by a fungus called Cryptococcus neoformans (C. neoformans) and occur in low-income tropical settings. The gold-standard treatment is a combination of three drugs: flucytosine and amphotericin B initially, followed by fluconazole. Yet, even on this gold-standard therapy, a third of patients die within 10 weeks of being diagnosed. Moreover, the drug flucytosine is severely restricted by availability and cost, meaning it is rarely used where the disease burden is highest.

Co-first author Nguyen Thi Thuy Ngan, Clinician at the Department of Tropical Medicine, Cho Ray Hospital, and the Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam, said: 'Tamoxifen has shown antifungal activity against various yeasts in the lab; we subsequently showed that it acts synergistically with amphotericin against two-thirds of clinical Cryptococcus isolates from our archive. As a well-understood, off-patent, cheap and widely available medicine, it was a promising candidate for treating cryptococcal meningitis.'

Read the full story on the University of Oxford website

Similar stories

Letter from the hills: The invisible burden of leprosy in Sumba

OUCRU Indonesia launches a new exhibition by photographer Yoppy Pieter based in Jakarta, Indonesia. This exhibition documents, through a series of intimate and beautiful images, the invisible burden of leprosy and other skin diseases in Sumba, an island in Nusa Tenggara Timor province, Indonesia.

Combating Antimicrobial Resistance

November 18 – 24 is World Antimicrobial Awareness Week. Antimicrobial resistance has been a key focus in OUCRU’s research for many years. Our objective is to understand and improve antimicrobial use and antimicrobial resistance in agriculture, the community, and hospitals. Our approach is interdisciplinary – led by a number of OUCRU’s research groups and public engagement teams.

OUCRU Engagement around mental health

OUCRU’s Public and Community Engagement team develops training and resources on the topic of stress management and communication skills. Run by the Public and Community Engagement team, the Youth Ambassadors programme also links young people to medical research that impacts their lives and connects researchers to the health issues that young people care about.

Abhilasha Karkey, new OUCRU Nepal Director

OUCRU Nepal is pleased to announce that as of 01 October 2022, Dr Abhilasha Karkey will assume the role of Director.

OUCRU presents a new virtual exhibition: Digital Diaries, Voices from the Pandemic, COVID-19 experiences in Asia

This online exhibition showcases short films and photographs created by health-care workers and community members and documents the socio-cultural impact of the COVID-19 pandemic in Indonesia, Nepal and Vietnam.

World Hepatitis Day: OUCRU research seeks to lower cost of treatment and improve access to care for patients with hepatitis C

Today is World Hepatitis Day. OUCRU and hospitals in Ho Chi Minh City and Hanoi have been collaborating on hepatitis C clinical trials since 2018. Our research is centred around predictive factors for selecting persons who could be successfully treated with shorter durations of antiviral therapy. OUCRU’s social science and public engagement teams are currently working with underrepresented groups to create community-led strategies to link care and treatment for populations at risk for viral hepatitis. Our aim is to have a more significant impact on the treatment strategy and access to care for patients with hepatitis C in Vietnam and worldwide in the future.