Tags: Cryptococcosis

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Oral ketoconazole is used in the treatment of blastomycosis, candidal infections (i.e., oropharyngeal and/or esophageal candidiasis, vulvovaginal candidiasis, candiduria, chronic mucocutaneous candidiasis),chromomycosis (chromoblastomycosis), coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis.

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Bioavailability of oral itraconazole varies depending on whether the drug is administered as capsules or as an oral solution, and the manufacturer states that these preparations should not be used interchangeably. Itraconazole oral solution (not itraconazole capsules) is indicated for the treatment of oropharyngeal or esophageal candidiasis.

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Itraconazole oral solution (but not itraconazole capsules) is used for the treatment of oropharyngeal and esophageal candidiasis. Itraconazole (given IV initially followed by itraconazole oral solution) is used for empiric antifungal therapy in febrile neutropenic patients. Oral itraconazole capsules are used in immunocompetent individuals for the treatment of tinea unguium (onychomycosis) of the toenail and/or fingernail caused by dermatophytes.

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While fluconazole can alter the pharmacokinetics of certain drugs that undergo hepatic metabolism, the magnitude of such alterations appears to be less than those associated with ketoconazole; however, comparative studies have not been performed to date. In addition, the possibility that the risk of developing such interactions may be increased at relatively high fluconazole dosages (e.g., 200 mg daily or more) should be considered. Results of studies evaluating combined use of fluconazole and amphotericin B in animal models of aspergillosis, candidiasis, or cryptococcosis have been conflicting.

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Fluconazole is administered orally or by IV infusion. Since absorption of fluconazole from the GI tract is rapid and almost complete, IV therapy with the drug generally is reserved for patients who do not tolerate or are unable to take the drug orally.

Amorolfine

Amorolfine is a morpholine derivative with antifungal activity. It appears to act by interfering with the synthesis of sterols essential for the functioning of fungal cell membranes. Amorolfine is active in vitro against a wide variety of pathogenic and opportunistic fungi including dermato-phytes, Blastomyces ckrmatitidis, Candida spp., Histoplasma capsulatum, and Sporothrix schenckii. It also has variable activity against Aspergillus spp.

Amphotericin B

Amphotericin B is active against Absidia spp., Aspergillus spp., Basidiobolus spp., Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Conidiobolus spp., Cryptococcus neoformans, Histoplasma capsulatum, Mucor spp., Paracoccidioides brasiliensis, Rhizopus spp., Rhodotorula spp., and Sporothrix schenckii.