Abstract Background Several recent randomized trials have been conducted in resource-limited settings for cryptococcal meningitis that have rapidly innovated international guidelines. The 2010 Infectious Diseases Society of America (IDSA) cryptococcal meningitis guideline has not been updated with recent trials. The 2022 AMBITION-cm trial found that a single 10-mg/kg dose of liposomal amphotericin B plus daily flucytosine and fluconazole for 2 weeks was noninferior to 1 week of amphotericin B deoxycholate with flucytosine. It is unknown whether physicians in high-resource settings are using this regimen or more traditional regimens. Methods We developed an electronic survey in June 2023 to better understand whether physician members of the IDSA Emerging Infections Network (EIN) and Mycoses Study Group Education and Research Consortium (MSG-ERC) had used the AMBITION-cm induction regimen, would use the regimen in hypothetical clinical scenarios, and what perceived barriers to use existed. Results A total of 242 of 561 (43%) physicians responded to the survey, of whom 205 provided care for persons with cryptococcal meningitis in the last year. Overall, 29 (14%) had used the AMBITION-cm regimen, and 176 (86%) had not. In various hypothetical clinical scenarios, only ∼10% of 209 respondents selected the AMBITION-cm regimen as preferred. Perceived barriers to uptake included the applicability of trials performed in low-resource settings to high-resource settings, that the regimen is not recommended in the 2010 IDSA guidelines, and the applicability to persons without HIV. Conclusions Most respondents had not used the single-dose liposomal amphotericin B regimen, but the regimen is being used. Further study of this regimen in other patient populations and settings is necessary.

lpox became the first infection to be eradicated, a huge triumph for science and humanity. Sadly, this impressive feat has only been replicated once since then with the eradication of rinderpest virus in 2011, and the words of Dubos seem as relevant today as they did in 1965. As the only two infections eradicated to date are viral, it is tempting to assume that viruses are the ideal candidates for eradication. To some extent, this is true. Viruses are obligate intracellular pathogens and if denied access to host cells through immunization by vaccination, transmission is prevented, and the virus will be unable to replicate, leading to its extinction. Smallpox was a sensible target for eradication as the virus had no animal reservoir or latent phase, an effective single dose vaccine existed and infection produced obvious clinical signs, allowing effective surveillance for infection (Henderson, 1998 ). By 2006, eradication efforts had reduced the worldwide incidence of poliomyelitis infection by 99% through the oral polio vaccine (OPV; Arita et al., 2006 ). The remaining 1% seems to be clustered in endemic areas (India, Pakistan, and certain African countries) and the main barrier now is not biological, but operational, e.g., security issues in Afghanistan and a funding deficit. However, a problem with live vaccines such as the OPV is that the strain can potentially revert back to a pathogenic form and this has been encountered with the OPV. Furthermore, unlike smallpox, poliomyelitis can be subclinical, making vaccine targeting difficult. On a positive note, the complete eradication of polio from the Americas suggests poliomyelitis eradication is possible. However, eradication of viral diseases is not a straightforward process. Indeed, there are viral diseases that appear impossible to eradicate due to certain characteristics of the causative virus. Herpes simplex virus resides latent in neurons, from where infection can reactivate. One cannot identify latently infect