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Itraconazole in the treatment of aspergillosis: a study of 16 cases
Abstract:
Itraconazole, a new triazole antifungal agent, has marked in vitro activity against filamentous fungi, particularly Aspergillus. We studied three groups of patients suffering from aspergillosis (16 cases): six affected with aspergilloma, three with allergic bronchopulmonary aspergillosis and seven with invasive aspergillosis. The survey consisted in clinical, radiological, mycological and serological evaluations with respect to drug plasma levels. Itraconazole was given at a dosage of 200-400 mg day-1 for periods ranging from 14 to 488 days. Out of the 16 patients, nine responded to therapy (recovery or improvement) and one failed to respond. Three patients improved but experienced relapses and three others could not be evaluated because of liver function disorders, so that treatment had to be stopped prematurely.
Insights
Itraconazole shows promise for treating various forms of aspergillosis, with nine out of sixteen patients responding positively. However, relapses and liver issues necessitate careful monitoring during antifungal therapy.
Area of Science:
- Mycology
- Pharmacology
- Infectious Diseases
Background:
- Aspergillosis is a serious fungal infection caused by Aspergillus species.
- Itraconazole is a novel triazole antifungal with demonstrated in vitro activity against filamentous fungi, including Aspergillus.
- Limited clinical data exists on itraconazole's efficacy across different aspergillosis manifestations.
Observation:
- A study evaluated 16 patients with aspergillosis (aspergilloma, allergic bronchopulmonary, and invasive forms).
- Patients received itraconazole at 200-400 mg/day for 14-488 days.
- Clinical, radiological, mycological, serological assessments, and drug plasma levels were monitored.
Findings:
- Nine out of sixteen patients showed a positive response (recovery or improvement).
- One patient did not respond to itraconazole treatment.
- Three patients experienced relapses after initial improvement.
- Three patients discontinued treatment due to liver function disorders, preventing full evaluation.
Implications:
- Itraconazole demonstrates clinical efficacy in a significant proportion of aspergillosis patients.
- The potential for relapses highlights the need for long-term management strategies.
- Hepatotoxicity is a concern, requiring vigilant monitoring of liver function during itraconazole therapy.
- Further research is warranted to optimize itraconazole dosing and duration for different aspergillosis types.