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Treatment of coccidioidal meningitis with fluconazole

R M Tucker1, J N Galgiani, D W Denning

  • 1Department of Medicine, Santa Clara Valley Medical Center, San Jose, California 95128.

Reviews of Infectious Diseases
|March 1, 1990
PubMed

Insights

Fluconazole shows promise for treating coccidioidal meningitis, with significant patient response rates. However, relapse can occur, indicating potential limitations with current fluconazole therapy durations and dosages.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Coccidioidal meningitis is a serious fungal infection requiring effective treatment.
  • Antifungal therapy is crucial for managing this invasive condition.

Observation:

  • Fluconazole was administered to 18 patients with coccidioidal meningitis at daily doses ranging from 50-400 mg.
  • Treatment duration averaged 9.8 months, with cerebrospinal fluid penetration assessed.

Findings:

  • 67% of assessable patients responded, and 7% showed partial response to fluconazole.
  • 5 of 8 patients receiving fluconazole as monotherapy responded or partially responded.
  • Toxicity was minimal, and cerebrospinal fluid penetration was substantial across all doses.

Implications:

  • Fluconazole demonstrates potential as a sole therapy for coccidioidal meningitis.
  • Relapse is a concern, suggesting a need for optimized dosing and treatment duration.
  • Further research is warranted to refine fluconazole treatment protocols for coccidioidal meningitis.

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