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Ketoconazole therapy for endemic blastomycosis.
Annals of Internal Medicine
|December 1, 1985
Summary
Ketoconazole shows promise for treating blastomycosis, offering a potential alternative to Amphotericin B. While adverse effects were noted, many patients achieved a cure, suggesting its efficacy in non-overwhelming cases.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Medicine
Background:
- Amphotericin B is a standard treatment for blastomycosis but is associated with significant adverse reactions.
- Blastomyces dermatitidis exhibits in-vitro susceptibility to ketoconazole, prompting investigation into its therapeutic potential.
Purpose of the Study:
- To evaluate the efficacy and safety of ketoconazole as a treatment for blastomycosis.
- To determine if ketoconazole can serve as an alternative to Amphotericin B in managing blastomycosis.
Main Methods:
- A study involving 46 patients diagnosed with blastomycosis.
- Administration of ketoconazole at a dosage of 400 mg/day.
- Follow-up of patients for a mean duration of 17 months.
Main Results:
- Thirty-five out of 43 patients who received at least one month of therapy achieved a cure without relapse.
- Six patients experienced relapse, with four attributed to noncompliance.
- Adverse effects were common but generally not severe.
Conclusions:
- Ketoconazole demonstrates a favorable cure rate in patients with blastomycosis.
- The findings suggest ketoconazole may be a viable alternative to Amphotericin B for initial treatment of non-overwhelming blastomycosis.
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