Therapeutic and safety evaluation of 200 mg/day itraconazole for 7 days inthe treatment of recalcitrant superficial mycoses - a preliminary report

BACKGROUND: Itraconazole is active against most human fungal pathogens and has been conventionally used in the treatment of tinea corporis/cruris at a dosage of 100 mg once daily for 75 days. Recently, a new regimen of 200 mg daily for 7 days has been shown to be equally effective, but there are no reports of the use of this new regimen in the Taiwanese population. METHODS: in this Open study, 17 patients with recalcitrant superficial myco ses were given 200 mg/day itraconazole for 7 days. All of them completed th e treatment and 11 patients returned for follow-up 4 weeks after the treatm ent. RESULTS: Cure or marked improvement at the end of the 7-day treatment perio d was in 10 of 17 patients while partial improvement was noted in 7 of 17 ( 41%). Four weeks after completion of the treatment, 9 of 11 (82%) remained cured or markedly improved, 1 of 11 (9%) was partially improved, and 1 of I I (9%) had relapsed. These findings were consistent with the grading of eac h clinical symptom of infection. Negative mycological evaluation at the end of treatment was found in 10 of 17 patients (59%), and ii weeks after the treatment it was found in 8 of 11 patients (73%), Itraconazole was well tol erated in all except two patients, one of whom developed belching and the o ther was bothered by polyuria and impotence, Both adverse effects subsided in these patients after discontinuation of the treatment. CONCLUSION: These results suggest that shorter treatment schedules with hig her doses are effective for the treatment of Taiwanese patients with recalc itrant superficial mycoses.