Tolerability of long-term fluconazole therapy
Matthew R Davis1, Minh-Vu H Nguyen2, Monica A Donnelley1
1Department of Pharmacy, University of California, Davis Health, Stockton Blvd., Sacramento, CA, USA.
The Journal of Antimicrobial Chemotherapy
|December 12, 2018
Summary
Long-term fluconazole therapy for coccidioidomycosis frequently causes adverse effects, with over half of patients experiencing issues like skin dryness and hair loss. Many patients required treatment adjustments due to these side effects.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Fluconazole is a widely used antifungal medication.
- Long-term use data for fluconazole tolerability is limited.
- Coccidioidomycosis treatment often requires extended or lifelong fluconazole therapy.
Purpose of the Study:
- To determine the frequency of adverse effects from long-term fluconazole use.
- To evaluate the impact of these adverse effects on treatment.
- To explore associations between dosage, serum levels, and adverse events.
Main Methods:
- Retrospective study at a single center.
- Included adult patients with coccidioidomycosis receiving fluconazole for at least 28 days.
- Analyzed adverse effect prevalence, interventions, and relation to dosage and serum levels.
Main Results:
- Over half of patients (51.6%) experienced adverse effects.
- Common side effects included xerosis, alopecia, and fatigue.
- Higher daily fluconazole doses were linked to adverse effects (P < 0.01).
- Two-thirds of affected patients needed treatment modification.
Conclusions:
- Long-term fluconazole therapy for coccidioidomycosis is associated with a significant incidence of adverse effects.
- These adverse events frequently necessitate changes in patient management.
- Findings reflect real-world clinical practice for long-term antifungal treatment.
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