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European experience with itraconazole in systemic mycoses
M A Viviani1, A M Tortorano, A Pagano
1Istituto di Igiene, Universita degli Studi di Milano, Italy.
Journal of the American Academy of Dermatology
|September 1, 1990
Summary
Itraconazole effectively treated deep fungal infections like aspergillosis and cryptococcosis in over 100 patients. The antifungal drug demonstrated good tolerance, even with long-term use, making it a viable treatment option.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Deep fungal infections pose significant health risks, particularly in immunocompromised individuals.
- Itraconazole is a broad-spectrum antifungal agent used for various mycoses.
- Limited data existed on itraconazole's efficacy and safety in a large cohort of Italian patients.
Purpose of the Study:
- To evaluate the efficacy and tolerance of itraconazole in treating deep fungal infections.
- To assess treatment outcomes for aspergillosis and cryptococcosis.
- To determine the effectiveness of itraconazole for both active infection and relapse prevention.
Main Methods:
- A retrospective analysis of over 100 patients treated with itraconazole (200-400 mg/day) from January 1985.
- Inclusion criteria focused on patients with sporotrichosis, aspergillosis, and cryptococcosis.
- Data collected included treatment response, relapse rates, and adverse events.
Main Results:
- Itraconazole monotherapy was effective in sporotrichosis and 24/34 aspergillosis cases, including 15/18 invasive pulmonary aspergillosis.
- For cryptococcosis, itraconazole alone cured 9/12 active infections; combined with flucytosine, it cured 8/10.
- Maintenance therapy showed low relapse rates (13%), with 42% complete cures and 45% showing antigen decline.
Conclusions:
- Itraconazole is an effective and well-tolerated treatment for deep fungal infections, including aspergillosis and cryptococcosis.
- The drug shows promise for both active infection treatment and long-term relapse prevention.
- Itraconazole's safety profile supports its use even in patients requiring prolonged therapy.