Journal Article

Treatment of Blastomycosis with Higher Doses of Fluconazole

Peter G. Pappas, Robert W. Bradsher, Carol A. Kauffman, Gretchen A. Cloud, Carolynn J. Thomas, G. Douglas Campbell, Stanley W. Chapman, Cheryl Newman and William E. Dismukes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 2, pages 200-205
Published in print August 1997 | ISSN: 1058-4838
Published online August 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514539
Treatment of Blastomycosis with Higher Doses of Fluconazole

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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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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