R 51211 (itraconazole) therapy of murine cryptococcosis

A new antifungal triazole, itraconazole (R51211), was compared with ketoconazole in treatment of murine cryptococcosis. Itraconazole is sparingly soluble in water, and must be administered orally in solvents such as polyethylene glycol. Serum concentrations are lower than those achieved with ketoconazole, but sustained for longer periods. Itraconazole was more effective than ketoconazole by MIC, but was similar to ketoconazole by minimum fungicidal concentration. Both drugs prolonged equally survival after intraperitoneal or intracerebral challenge with Cryptococcus neoformans. Tissue counts of C. neoformans were similar in mice treated with either drug. Neither drug sterilized brains of mice challenged intracerebrally. Itraconazole appears equally potent as ketoconazole, but in this model does not appear to offer any therapeutic advantage over ketoconazole.