The Modern Revolution in Antifungal Drug Therapy

Graybill, John R.

doi:10.1007/978-1-4613-0655-9_25

Cited by 2 publications

(5 citation statements)

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“…These invasive infections usually occur in patients with no identifiable immune defects. 5 Gumaa et al have documented the benefit of itraconazole given immediately after surgery,3 but we present a case of serious, long-standing disease successfully treated several years after surgery despite significant deterioration and an apparently poor prognosis.…”

mentioning

confidence: 72%

“…There have been no reports of serious toxicity 3 . Graybill has drawn attention to the importance of avoiding interaction with H 2 ‐antagonists and antacids, which significantly reduce bioavailability of the capsule formulation 5 …”

Section: Discussionmentioning

confidence: 99%

“…Invasive aspergillosis normally occurs in patients without obvious immune deficiency; 12 more rapidly progressive fulminant aspergillosis has been reported in the immunocompromised 5 . Progressive chronic necrotising pulmonary aspergillosis also carries a poor prognosis, 15 although itraconazole has been used successfully in one patient 16 …”

Section: Discussionmentioning

confidence: 99%

“…However, a rapidly progressing invasive infection, or chronic focal invasive aspergillosis, may also occur; this carries a high risk of life‐threatening sequelae, such as thrombosis and cerebral involvement. These invasive infections usually occur in patients with no identifiable immune defects 5 …”

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confidence: 99%

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Management of Invasive Aspergillosis With Itraconazole

Hakim

Milne

Fox

et al. 1993

Int J Clinical Practice

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confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Management of Invasive Aspergillosis With Itraconazole

Hakim

Milne

Fox

et al. 1993

Int J Clinical Practice

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“…The aim of this study was to evaluate the activity of itraconazole both in vitro against Cr. neOfOrmans and in the treatment of experimental cryptococcosis, in order to determine its position in the therapeutic armoury [46].…”

Section: Introductionmentioning

confidence: 99%

Therapy of experimental meningeal and disseminated cryptococcosis

Cutsem

1993

Mycoses

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Summary. This study evaluated the efficacy of itraconazole, a broad‐spectrum triazole antifungal drug, which has previously been demonstrated to exhibit activity against Candida albicans C. krusei, C. glabrata, Aspergillus, Histoplasma and Blastomyces as a potential treatment for cryptococcosis. The susceptibility of 62 strains of Cryptococcus neoformans was tested in vitro. All strains were inhibited by itraconazole 0.1 μg ml‐1. Itraconazole was fungicidal after replenishment at a concentration that can easily be achieved in viva. When mice were infected intracerebrally with Cr. neoformans all control animals died, whereas only 11% and 26% of itra‐conazole‐treated animals died. In a group treated with ketoconazole, 67% died. After intravenous infection, 30% of control guinea pigs died, while other animals treated with itraconazole (5 or 10 mgkg‐1) or amphotericin B (1.25 or 2.5 mg kg‐1) all survived. Itraconazole 10 mg kg‐1 produced the best results, with brain and meningeal cultures becoming negative in 55–64% of animals. In addition, intravenously infected guinea pigs received oral or intraperitoneal treatment with itraconazole or fluconazole (each 5 or 10mgkg‐1) as monotherapy or in combination. Although both treatments were active, itraconazole 10 mg kg‐1 was the most effective. In two out of six immunosuppressed guinea pigs infected with Cr. neoformans oral itraconazole was effective, resulting in negative brain and meningeal cultures. A combination of itraconazole (5 mgkg‐1) with flucytosine or amphotericin B was more efficacious than monotherapy. Therefore, itraconazole is a potentially effective therapy for the treatment of Cyptococcus infection when administered either alone or in combination with other antifungal drugs. It may also be effective in immunocom‐promised patients. Zusammenfassung. Ziel dieser Studie war es, die Wirksamkeit von Itraconazol zu evaluieren. Hierbei handelt es sich um ein Breitband‐Antimykotikum aus der Gruppe der Triazole, dessen Aktivität gegen Candida albicans, C. krusei, C. glabrata, Aspergillus, Histoplasma und Blastomyces kürz‐lich nachgewiesen wurde und das damit als mögli‐ches Therapeutikum der Cryptococcose in Frage kommt. Es wurden 62 Stämme von Cyptococcus neofomans auf ihre Empfindlichkeit in vitro getestet, wobei alle durch 0.1 pg ml‐1 Itraconazol gehemmt wurden. Nach weiterer Zugabe wirkte Itraconazol fungizid in einer Konzentration, die sich in viva leicht erreichen läß. Wurden Mäuse intrazerebral mit Cr. neoformans infiziert, starben alle Tiere der Kontrollgruppe, während von den mit Itraconazol behandelten Tieren nur 11% und 26% starben. Bei einer Behandlung mit Ketoconzaol starben 67O/O. Nach einer intravenösen Infektion starben 30% einer Kontrollgruppe von Meerschweinchen, wogegen alle Tiere überlebten, die entweder mit Itraconazol (5 oder 10 mgkg‐1) oder Amphotericin B (1.25 oder 2.5 mgkg‐1) behandelt wurden. Die besten Ergebnisse zeigte Itraconazol in einer Konzentration von 10 mgkg‐1 im Falle von Erre‐gerkulturen aus Gehirn und Hirnhäuten: Diese wurden in...

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The Modern Revolution in Antifungal Drug Therapy

Cited by 2 publications

References 54 publications

Management of Invasive Aspergillosis With Itraconazole

Management of Invasive Aspergillosis With Itraconazole

Therapy of experimental meningeal and disseminated cryptococcosis

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