Fluconazole in the treatment of chronic pulmonary and nonmeningeal disseminated coccidioidomycosis. NIAID Mycoses Study Group.
Am J Med
; 98(3): 249-56, 1995 Mar.
Article
en En
| MEDLINE
| ID: mdl-7872341
ABSTRACT
PURPOSE:
To determine the efficacy and safety of fluconazole as treatment for coccidioidomycosis. PATIENTS ANDMETHODS:
This was a multicenter, open-label, single-arm study. Of 78 patients enrolled, 22 had soft-tissue, 42 had chronic pulmonary, and 14 had skeletal coccidioidomycosis. Forty-nine had at least one concomitant disease, 7 of whom had HIV infection. Patients were given oral fluconazole 200 mg/d. Nonresponders were increased to 400 mg/d. Treatment courses were long a mean of 323 +/- 230 days at 200 mg and 433 +/- 178 days at 400 mg. Predefined assessment of disease-related abnormalities was performed at the time of enrollment and repeated at least every 4 months. A satisfactory response was defined as any reduction of baseline abnormality by month 4 and at least 51% reduction by month 8.RESULTS:
Among 75 evaluable patients, a satisfactory response was observed in 12 (86%) of the 14 patients with skeletal, 22 (55%) of the 40 patients with chronic pulmonary, and 16 (76%) of the 21 patients with soft-tissue disease. Five patients (7%) required modification of treatment due to toxicity. Forty-one patients who responded were followed off drug. Fifteen (37%) of them experienced reactivation of infection.CONCLUSION:
Fluconazole 200 or 400 mg/d is well tolerated and a moderately effective treatment for chronic pulmonary or nonmeningeal disseminated coccidioidomycosis. The relapse rate following therapy is high. Treatment trials with higher doses appear warranted. The relative efficacy of fluconazole versus other azoles or amphotericin B remains unknown.
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Banco de datos:
MEDLINE
Asunto principal:
Fluconazol
/
Coccidioidomicosis
/
Enfermedades Pulmonares Fúngicas
Tipo de estudio:
Clinical_trials
Límite:
Adult
/
Aged
/
Aged80
/
Humans
/
Middle aged
Idioma:
En
Año:
1995
Tipo del documento:
Article