title: Treatment of blastomycosis with higher doses of fluconazole. The National Institute of Allergy and Infectious Diseases Mycoses Study Group.
abstract: Recent clinical data suggest that fluconazole at daily doses of 200 to 400 mg for at least 6 months is moderately effective therapy for non-life-threatening blastomycosis. To examine the usefulness of higher doses of fluconazole therapy for this disorder, we conducted a multicenter, randomized, open-label study to determine the efficacy and safety of two different daily doses of fluconazole (400 and 800 mg) in the treatment of non-life-threatening blastomycosis. Of 39 patients evaluable for efficacy analysis, 34 (87%) were successfully treated, including 89% and 85% of patients who received 400 and 800 mg, respectively. Five (83%) of six patients for whom prior antifungal therapy had failed were successfully treated. The mean duration of therapy was 8.9 months for successfully treated patients. Nineteen patients (48%) reported adverse events, although most were minor. We conclude that fluconazole at daily doses of 400 to 800 mg for at least 6 months is effective therapy for non-life-threatening blastomycosis.
authors.affiliation: Division of Infectious Diseases, University of Alabama at Birmingham, USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Pappas
authors.forename: R W
authors.initials: RW
authors.lastname: Bradsher
authors.forename: C A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: G A
authors.initials: GA
authors.lastname: Cloud
authors.forename: C J
authors.initials: CJ
authors.lastname: Thomas
authors.forename: G D
authors.initials: GD
authors.lastname: Campbell
authors.forename: S W
authors.initials: SW
authors.lastname: Chapman
authors.forename: C
authors.initials: C
authors.lastname: Newman
authors.forename: W E
authors.initials: WE
authors.lastname: Dismukes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001759:Blastomycosis / Q000188:drug therapy*; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole