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Ketoconazole: clinical evaluation in severe fungal infections
Abstract:
Ketoconazole, a new imidazole-derivative antifungal agent, has been studied in sixteen patients with systemic fungal infections. Seven patients had deep localized infections (three cases with pneumonia and one case each with urinary infection, osteomyelitis, endophthalmitis and peritonitis); three patients suffered from granulomatous or acute mucocutaneous infections and six patients had fungal septicemia. All patients suffered from severe underlying diseases and/or predisposing factors such as antibiotic treatment, immunosuppressive therapy or indwelling catheters. Candida albicans was isolated in 13 cases, C. parapsilosis (septicemia), Aspergillus (ophthalmitis) and Mucor (pneumonia) in the other three cases. Ketoconazole was administered orally at daily dosages of 400-800 mg; 5-fluorocytosine was associated in four cases. Out of the ten patients with localized infections, seven were cured and three improved. Two of the six septic patients were cured, one improved who subsequently died from Pseudomonas septic shock and three patients showed no improvement. Two relapses were recorded, both followed by further eradication. The tolerance of the drug was always excellent. Ketoconazole proved a very effective and well-tolerated drug in systemic infections, caused by opportunistic fungi in high-risk patients.
Insights
Ketoconazole, an imidazole antifungal, effectively treated systemic fungal infections in high-risk patients. This well-tolerated oral medication showed excellent results for localized and septic cases.
Area of Science:
- Mycology
- Pharmacology
- Infectious Diseases
Background:
- Systemic fungal infections pose significant risks, especially in immunocompromised patients.
- Opportunistic fungal pathogens like Candida albicans are common causes of severe infections.
- Patients with severe underlying diseases and predisposing factors require effective antifungal therapies.
Purpose of the Study:
- To evaluate the efficacy and tolerability of ketoconazole in patients with systemic fungal infections.
- To assess ketoconazole's effectiveness against various fungal species and infection types.
- To determine the safety profile of oral ketoconazole in a high-risk patient population.
Main Methods:
- A study involving sixteen patients with systemic fungal infections.
- Ketoconazole administered orally at daily dosages of 400-800 mg.
- Co-administration of 5-fluorocytosine in four patients.
Main Results:
- Seven out of ten patients with localized infections were cured, and three improved.
- Two of six patients with fungal septicemia were cured, and one improved.
- Ketoconazole demonstrated excellent tolerability with no adverse events reported.
Conclusions:
- Ketoconazole is a highly effective and well-tolerated oral antifungal agent for systemic infections.
- The drug is particularly beneficial for high-risk patients with opportunistic fungal infections.
- Further research may explore its role in managing complex mycoses.