LONG-TERM ITRACONAZOLE PROPHYLAXIS AGAINST ASPERGILLUS INFECTIONS IN 32 PATIENTS WITH CHRONIC GRANULOMATOUS-DISEASE

We conducted a prospective, open study of oral itraconazole therapy (5 and then 10 mg/kg per day) to assess tolerance and potential efficacy in preventing fungal infections in patients with chronic granulomatou s disease. Thirty-two patients were enrolled In one center between 198 5 and 1991. Tolerance was excellent in all cases. Poor compliance was suspected In three cases. Two patients were excluded from efficacy ana lysis because itraconazole was used as part of therapy for pulmonary a spergillosis. Of 30 patients, 3 developed a fungal (Aspergillus) lung infection, an incidence 3.4/100 patient-years versus 11.5 in a histori cal control group that did not receive any prophylaxis (p = 0.13) and 9.55 in a historical group of patients who received daily ketoconazole prophylaxis (p = 0.19). The percentage of patients infected with Aspe rgillus was significantly different: 10% in the itraconazole group ver sus 34.4% in the untreated group (P = 0.013). These results require fu rther evaluation through a comparative randomized trial to assess the possible benefit of itraconazole prophylaxis in patients with chronic granulomatous disease.