Itraconazole for the treatment of pulmonary aspergillosis in heart transplant recipients.
The objective of this study was to evaluate the effects of itraconazole as a first choice drug in the treatment of pulmonary aspergillosis in heart transplant recipients. Heart transplant recipients suffering from invasive pulmonary aspergillosis were included in this study. Group 1 included 4 patients treated with i.v. itraconazole (Janssen Pharmaceutica) 400 mg daily, as a first choice drug for 28 d. Itraconazole was discontinued and amphotericin-B was started before the 28th day if clinical or radiographic worsening was observed. Group 2 included 3 patients treated with amphotericin-B as a first choice drug. Itraconazole was discontinued in all patients of Group 1 after 12-26 d of treatment because of radiographic worsening (n = 3) or combined clinical and radiographic worsening (n = 1). Subsequent treatment with amphotericin-B resulted in improvement of all patients. On a 5-yr follow-up period no relapse of aspergillosis was observed in 3 of them. The fourth patient expired from cerebral hemorrhage. The 3 patients of Group 2 treated with amphotericin-B showed a gradual improvement, and all were doing well on a 2-yr follow-up. In conclusion, in our study population consisted of heart transplant recipients amphotericin-B was superior to itraconazole in the treatment of invasive pulmonary aspergillosis.
Nanas
J N
JN
University of Athens, School of Medicine, Department of Clinical Therapeutics, Alexandra Hospital, Greece.
Saroglou
G
G
Anastasiou-Nana
M I
MI
Kostis
E B
EB
Petrochilou-Paschou
V P
VP
Kontoyannis
D A
DA
Stamatelopoulos
S F
SF
Moulopoulos
S D
SD
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D016027:Heart Transplantation; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009894:Opportunistic Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B