NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES MYCOSES STUDY GROUP*
In a multicenter prospective randomized trial, the efficacy and toxicity of low-dose (400 mg/d) and high-dose (800 mg/d) oral ketoconazole were compared in 80 patients with blastomycosis and in 54 with histoplasmosis. Among 65 patients with blastomycosis treated for 6 months or more, high-dose treatment was more effective (100% success rate compared with 79%;p = 0.001). Among 19 patients with chronic cavitary histoplasmosis treated for 6 months or more, both regimens were equally effective (overall success rate, 84%). In 20 patients with localized or disseminated histoplasmosis treated for 6 months or more, low-dose treatment was more effective (100% success rate compared with 57%;p = 0.03). The success rate for all patients with histoplasmosis treated for 6 months or more was 85%. Adverse effects occurred in 81 of 134 patients (60%) and were commoner with the high-dose regimen. Ketoconazole is effective for immunocompetent patients with non-life-threatening, nonmeningeal forms of blastomycosis and histoplasmosis. Because of the higher frequency of side effects associated with the high dose, ketoconazole therapy should be initiated with the low dose.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES MYCOSES STUDY GROUP*. Treatment of Blastomycosis and Histoplasmosis with Ketoconazole: Results of a Prospective Randomized Clinical Trial. Ann Intern Med. 1985;103:861–872. doi: 10.7326/0003-4819-103-6-861
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Published: Ann Intern Med. 1985;103(6_Part_1):861-872.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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