TREATMENT OF ASPERGILLOSIS WITH ITRACONAZ OLE

Itraconazole is a new antifungal triazole. It is the first to cover As pergillus sp. Its clinical efficacy has been documented in allergic br oncho-pulmonary aspergillosis, pulmonary aspergilloma and chronic necr otizing pulmonary aspergillosis. Although amphotericin B remains the f irst line therapy of invasive aspergillosis (IA) in immunosuppressed p atients, several reports clearly documented promising results of itrac onazole in such diseases, especially in IA occuring in neutropenic pat ients. However, itraconazole is most often prescribed when amphoterici n B is inefficient or not well-tolerated or if the persistance of immu nodeficiency requires a secondary prophylaxis. Controlled studies are yet in progress to confirm hopes rose by itraconazole in the primary p rophylaxis of fungal infections in neutropenic patients. Because itrac onazole's bioavaibility is unpredictable, use of loading doses and reg ular monitoring of serum levels is necessary. New galenic forms (oral solution and intra-venous preparation) and controlled trials will perm it new approaches on indications of itraconazole in neutropenic patien ts.