title: Itraconazole: Precautions regarding drug interactions and bioavailability.
abstract: OBJECTIVE
  To describe patients with fungal infections in whom drug interactions and bioavailability problems were associated with itraconazole treatment failure.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Two tertiary care university-affiliated teaching hospitals.
  
  
  METHODS
  Itraconazole-treated patients between 1990 and 1992.
  
  
  RESULTS
  Four patients treated with itraconazole were identified in whom suboptimal serum itraconazole levels were associated with relapse of disseminated histoplasmosis, treatment failure of invasive aspergillosis or development of superficial mycoses. Low serum itraconazole levels were associated with concurrent therapy with rifampin or agents inhibiting gastric acid secretion, with administration of itraconazole capsule contents through a nasogastric tube or with the presence of aids.
  
  
  CONCLUSIONS
  It is recommended that serum itraconazole levels be measured in patients with potentially life-threatening mycoses if coexistent factors may interfere with itraconazole therapy.
authors.affiliation: Department of Medicine, St Paul's Hospital, and Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia.
authors.forename: M P
authors.initials: MP
authors.lastname: Puttick
authors.forename: P
authors.initials: P
authors.lastname: Phillips