Treatment of refractory feline sporotrichosis with a combination of intralesional amphotericin B and oral itraconazole

Abstract

OBJECTIVE To describe the use of intralesional amphotericin B in localised lesions for the treatment of 26 cats from Rio de Janeiro, Brazil, with sporotrichosis refractory to oral itraconazole. DESIGN Uncontrolled intervention study. METHOD The 26 cats in this study were diagnosed with sporotrichosis, confirmed by isolation of Sporothrix schenckii, and presented residual localised skin lesions refractory to treatment with oral itraconazole for a minimum period of 8 weeks. The animals received weekly applications of intralesional amphotericin B in conjunction with oral itraconazole. In cases of owner unavailability, a maximum of 2 weeks between the infiltrations was accepted. RESULTS Twenty-two (84.6%) of the 26 treated cats achieved clinical remission, 16 (72.7%) of which were cured, and in the remaining six (27.3%) the lesions recurred at the same site. Lack of clinical response was observed in one animal and three owners abandoned treatment. CONCLUSION The proposed therapeutic regimen is an adjunctive treatment option for cats with sporotrichosis presenting as residual skin lesions refractory to itraconazole.

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

“…The similar susceptibilities to KET and ITR between cat and human strains in our study support the idea of clonal transmission of sporotrichosis between cats and humans in Rio de Janeiro (Rodrigues et al 2014b). To the best of our knowledge, TRB was not used to treat domestic animals with sporotrichosis during the study period, and intralesional AMB was used only in association with oral ITR in cases refractory to this azole (Gremião et al 2011). …”

Terapêutica Da Esporotricose: Revisão

“…Este protocolo, bem como o uso de uma fluidoterapia (solução de cloreto de sódio a 0,9%) prévia, parece diminuir a probabilidade de nefrotoxicidade nos pacientes (ADAMS, 2003). Estudos descreveram o uso, com sucesso, da anfotericina B intralesional em associação com o itraconazol por via oral, em felinos com esporotricose refratária a monoterapia com o azol (GREMIÃO et al, 2009(GREMIÃO et al, , 2011.…”

Anti- Sporothrix spp. activity of medicinal plants

“…The conventional therapy for sporotrichosis includes the use of antifungal agents such as potassium iodide, itraconazole, ketoconazole, amphotericin B and terbinafine, among others, as well as the adoption of local thermal therapy and the surgical excision of the lesion Gremião et al, 2009;Honse et al, 2010;Pereira et al, 2011;Gremião et al, 2011;Reis et al, 2012). The preferred antifungal therapy for cat and dogs with sporotrichosis has been itraconazole administered daily orally at the dose of 10 to 40 mg kg -1 for a minimum period of three months and up to one year with no apparent adverse effects (Madrid et al, 2010;Larsson, 2011;Rossi et al, 2013).…”

“…The preferred antifungal therapy for cat and dogs with sporotrichosis has been itraconazole administered daily orally at the dose of 10 to 40 mg kg -1 for a minimum period of three months and up to one year with no apparent adverse effects (Madrid et al, 2010;Larsson, 2011;Rossi et al, 2013). However, poor clinical response has been observed in cats with sporotrichosis (Gremião et al, 2011).…”

“…The association of subcutaneous amphotericin B with oral itraconazole is also an alternative in cats with sporotrichosis refractory to itraconazole (Gremião et al, 2011). Furthermore, the association of itraconazole with (1-3) β-glucan promoted the case resolution after four weekly applications of glucan in a canine with refractory sporotrichosis to itraconazole by Sporothrix brasiliensis and it may be considered a promising alternative in cases of resistance to conventional therapy (Guterres et al, 2014).…”