ITRACONAZOLE FOR THE TREATMENT OF HISTOPLASMOSIS AND BLASTOMYCOSIS

Itraconazole is a triazole compound with broad-spectrum antifungal act ivity which includes the pathogenic yeasts, certain Aspergillus specie s, and the endemic fungi such as Histoplasma capsulatum and Blastomyco sis dermatitidis. Although prospective trials comparing itraconazole t o other azoles and amphotericin B are unavailable, recently published data suggest that itraconazole is the drug of choice for patients with mild to moderate histoplasmosis and blastomycosis without central ner vous system involvement. Among patients with the acquired immunodefici ency syndrome and histoplasmosis, itraconazole has emerged as an effec tive alternative to amphotericin B for induction therapy in selected p atients, and has largely replaced amphotericin B for chronic maintenan ce therapy in these patients. For patients with severe or life-threate ning histoplasmosis or blastomycosis and for patients with central ner vous system involvement, amphotericin B remains the initial therapy of choice.