TREATMENT OF BLASTOMYCOSIS WITH FLUCONAZOLE - A PILOT-STUDY

There are few clinical data concerning the use of fluconazole, a triaz ole antifungal agent with in vitro activity against Blastomyces dermat itidis, in the treatment of human blastomycosis, We conducted a multic enter, randomized, open-label pilot trial comparing two daily doses of fluconazole (200 mg and 400 mg) in the treatment of non-life-threaten ing, non-CNS blastomycosis. Twenty-four patients were enrolled in the study, and 23 patients were evaluable for efficacy analysis. Overall, treatment of 15 (65%) of 23 patients was successful, including eight ( 62%) of 13 who received 200 mg daily and seven (70%) of 10 who receive d 400 mg daily. The mean duration of therapy for successfully treated patients was 6.7 months. Of the six patients whose prior antifungal th erapy had failed, all six eventually responded to fluconazole treatmen t, We conclude that fluconazole (200 mg to 400 mg daily) given for at least 6 months is moderately effective treatment for blastomycosis.