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Itraconazole in antifungal therapy
J D Cleary1, J W Taylor, S W Chapman
1Department of Clinical Pharmacy Practice, University of Mississippi, Jackson 39216.
The Annals of Pharmacotherapy
|April 1, 1992
Summary
Itraconazole shows promising efficacy and safety for treating deep fungal infections, potentially replacing ketoconazole. Further research is needed, especially for immunocompromised patients and with newer antifungal agents.
Area of Science:
- Pharmacology
- Mycology
- Infectious Diseases
Background:
- Antifungal pharmacotherapy is crucial for managing mycotic infections.
- Itraconazole represents a significant agent in antifungal treatment regimens.
- Comparative data on antifungal agents are essential for clinical decision-making.
Purpose of the Study:
- To compare and contrast the pharmacotherapy of itraconazole with other antifungal agents.
- To evaluate the efficacy, pharmacokinetics, and safety of itraconazole.
- To assess the potential role of itraconazole in treating systemic mycoses.
Main Methods:
- Comprehensive literature search of primary sources on itraconazole (1976-1991).
- Inclusion of diverse study designs, including case reports and observational data.
- Systematic data extraction focusing on mechanism of action, pharmacokinetics, efficacy, drug interactions, and adverse reactions.
Main Results:
- Encouraging efficacy data for itraconazole in deep mycotic infections, despite limited controlled trials.
- Favorable pharmacokinetic profile allowing once- or twice-daily dosing.
- Itraconazole demonstrates good safety and tolerability in patients.
Conclusions:
- Itraconazole is recommended as a safer and more effective alternative to ketoconazole in hospital formularies.
- Its role in prophylaxis for immunocompromised hosts requires further investigation.
- Ongoing evaluation is necessary with the emergence of new imidazole and triazole antifungals.