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. Author manuscript; available in PMC: 2017 Jul 1.
Published in final edited form as: Lancet Infect Dis. 2016 Mar 10;16(7):809–818. doi: 10.1016/S1473-3099(16)00074-8

Figure 4. Probability of Achieving Therapeutic Sertraline brain tissue levels based on Cryptococcus Susceptibility and Sertraline Dose in a Population.

Figure 4

Based on the steady state levels achieved between day 7 and 14 as well as the distribution of MICs, in Monte Carlo simulation 81% of a population would likely achieve therapeutic sertraline levels in the brain with 400mg/day, 65% of those ART-naïve receiving 200mg/day, and 35% of those receiving ART with 200mg/day. In the presence of 2-fold additive/synergistic effects of fluconazole, 97% at 400mg/day, 90% at 200mg/day without ART, and 62% at 200mg/day on ART would achieve therapeutic sertraline activity in brain. Overall, 91% (117/128) of Cryptococcus isolates exhibited a MIC of ≤6 µg/mL, 84% (108/128) with ≤4 µg/mL, and 27% (35/128) with MIC ≤2 µg/mL.