Pulmonary aspergillomata in a child treated with clotrimazole.

Evans, E. G. V.; Watson, D A; Matthews, N. R.

doi:10.1136/bmj.4.5787.599

Cited by 18 publications

(7 citation statements)

References 2 publications

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“…Sev-eral reports indicate that this agent has broad in vitro antifungal activity against both pathogenic yeasts and filamentous fungi (10,12,16,23). The in vivo activity of clotrimazole in experimental fungal infections in animals is variable (12,15,23), and, although clinical activity has been reported (4,9,11) phosphatase. There was an interval of at least 48 hr between studies in the same individuals, and all studies were done after an overnight fast.…”

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Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Burgess

Bodey

1972

Antimicrob Agents Chemother

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Clotrimazole (Bay b 5097) is a new synthetic antifungal drug with in vitro activity against Candida spp., Torulopsis glabrata, and Saccharomyces spp. Pharmacological studies in man after the oral administration of 1.5 and 3 g of clotrimazole produced mean peak concentrations in the serum of 1.16 and 1.29 mg/ml, respectively, 2 hr after administration. In six patients taking 1.5 g of clotrimazole every 6 hr, there was a progressive decline in the serum concentrations after administration of a dose on days 1, 4, and 8. Nine other patients begun on a similar schedule manifested gastrointestinal symptoms attributed to the clotrimazole and were unable to complete the study. Concentrations of active drug in the urine were less than 1 N of the administered dose.Systemic fungal infections contribute significantly to the morbidity and mortality of patients with hematological malignancies (1, 7) and of transplant patients receiving immunosuppressive therapy (13,17,20 (Fig. 1). Several reports indicate that this agent has broad in vitro antifungal activity against both pathogenic yeasts and filamentous fungi (10,12,16,23 phosphatase. There was an interval of at least 48 hr between studies in the same individuals, and all studies were done after an overnight fast. Single-dose studies were performed in seven normal volunteers and one cancer patient with doses of 1.5 and 3 g of clotrimazole. Serum specimens were collected immediately prior to each study and at 1, 2, 3, 4, and 6 hr after administration of the drug. Urine specimens were collected immediately prior to each study and for 6 hr after drug administration.To determine the effect of multiple dosing on serum levels, 15 cancer patients being treated for their disease in protected-environment units (2) were begun on clotrimazole, 1.5 g every 6 hr for 8 days. All of these patients were receiving prophylactic oral nonabsorbable antibacterial antibiotics (3) but no other antifungal agents during the period of study. The studies 423 Vol. 2,No. 6

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confidence: 99%

Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Burgess

Bodey

1972

Antimicrob Agents Chemother

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“…The only other agent of significance is 5-fluorocytosine which has a limited spectrum of antifungal activity, and its use in therapy frequently leads to the emergence of resistant strains (13,18). Clotrimazole and miconazole have been evaluated in the treatment of systemic mycoses, each with limited success (6,7,11,13,15,20,24). Orally administered clotrimazole is frequently associated with gastrointestinal intolerance (13,14,24) and, since parenteral formulations are not available, its value in systemic therapy is severely limited.…”

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confidence: 99%

Antifungal Activity of Tioconazole (UK-20,349), a New Imidazole Derivative

Jevons

Gymer

Brammer

et al. 1979

Antimicrob Agents Chemother

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Tioconazole (UK-20,349), a new antifungal imidazole derivative, was compared with miconazole for activity in vitro against Candida spp., Torulopsis glabrata, Cryptococcus neoformans, Aspergillus spp., and dermatophyte fungi ( Trichophyton spp. and Microsporum spp.). Tioconazole was more active than miconazole against all the fungal species examined except Aspergillus , against which both agents showed similar activity. Both tioconazole and miconazole inhibited the growth of all fungi examined at concentrations well below their quoted minimum inhibitory concentrations. Their activity against fungi in vivo was investigated in mice infected systemically with Candida albicans . Both agents significantly reduced the numbers of viable Candida cells recoverable from the kidneys of infected animals, with tioconazole producing a generally more marked reduction. After administration of a single oral dose (25 mg/kg) to beagle dogs or white mice, higher and more sustained circulating levels of bioactive drug were detectable of tioconazole than of miconazole. These observations suggest that tioconazole may have potential in the treatment of both superficial and systemic mycoses in humans.

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“…In one clinical case, Evans et al [6] described the suc cessful management of pulmonary aspergillosis in a child by using systemic therapy with clotrimazole at daily doses of 70 mg/kg for 45 days; previously, inhalation of nystatin (120,000 units daily) and cephalexin (750 mg daily), and ir rigation of the pleural space with nystatin suspension (500,000 units) for 6 days failed to cure the disease. During therapy, clotrimazole was tolerated well [6], In a contradictory report.…”

Section: Clotrimazolementioning

confidence: 99%

“…During therapy, clotrimazole was tolerated well [6], In a contradictory report. Milne [7] revealed the lack of mycological and clinical improvement in 4 patients with bronchopulmonary aspergillosis treated with daily doses of 11X) mg/kg clotrimazole for up to 3 months.…”

Section: Clotrimazolementioning

confidence: 99%