TREATMENT OF BLASTOMYCOSIS WITH HIGHER DOSES OF FLUCONAZOLE

Recent clinical data suggest that fluconazole at daily doses of 200 to 400 mg for at least 6 months is moderately effective therapy for non- life-threatening blastomycosis. To examine the usefulness of higher do ses of fluconazole therapy for this disorder, we conducted a multicent er, randomized, open-label study to determine the efficacy and safety of two different daily doses of fluconazole (400 and 800 mg) in the tr eatment of non-life-threatening blastomycosis, Of 39 patients evaluabl e for efficacy analysis, 34 (87%) were successfully treated, including 89% and 85% of patients who received 400 and 800 mg, respectively, Fi ve (83%) of six patients for whom prior antifungal therapy had failed were successfully treated, The mean duration of therapy was 8.9 months for successfully treated patients. Nineteen patients (48%) reported a dverse events, although most were minor, We conclude that fluconazole at daily doses of 400 to 800 mg for at least 6 months is effective the rapy for non-life-threatening blastomycosis.