Preliminary Pilot Study of Itraconazole After a Single Oral Dose of a Veterinary Formulation Solution in African Penguins (Spheniscus demersus)

Zalesak, Selina M.; Sánchez, Carlos R.; Pich, Ashley A.; Papich, Mark G.

doi:10.1647/1082-6742-34.1.52

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…The use of posaconazole in dogs is off‐label, but all antifungal drug treatment in animals requires off‐label use of drugs with the exception of the veterinary formulation of itraconazole solution, labeled for cats with ringworm ( https://vetlabel.com/lib/vet/meds/itrafungol-1/ ). 31 It is possible that lower doses or different dosing schedules could also be efficacious, but this would require a prospectively designed study to investigate systematically. Finally, there was no control over the sourcing of the posaconazole in this retrospective review and serum concentrations might be affected by the formulation used.…”

Section: Discussionmentioning

confidence: 99%

Posaconazole treatment of refractory coccidioidomycosis in dogs

Shubitz

Schlacks²,

Vishkautsan³

et al. 2021

Veterinary Internal Medicne

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Background The majority of dogs with coccidioidomycosis recover with administration of fluconazole or itraconazole, although some cases are refractory or the dogs do not tolerate administration of these medications. Objectives The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole. Animals Eight dogs with refractory coccidioidomycosis. Methods Retrospective case series. Medical records from Veterinary Specialty Center of Tucson were searched to identify dogs with refractory coccidioidomycosis that were treated with posaconazole. Clinical information and the results of monitoring trough serum posaconazole concentrations were retrieved. Results Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10 mg/kg per day of posaconazole. Six of 8 dogs recovered or developed clinical remission while administered posaconazole. Thirteen serum concentrations from 8 dogs tested were >1 μg/mL (range, 1.52 to >6 μg/mL) and the drug was well‐tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis. Conclusions and Clinical Importance Posaconazole should be considered as a treatment option for dogs with refractory coccidioidomycosis. Monitoring of indicators of liver function or injury along with therapeutic drug monitoring is recommended to tailor dosage in the event of hepatic toxicosis.

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Section: Discussionmentioning

confidence: 99%

Posaconazole treatment of refractory coccidioidomycosis in dogs

Shubitz

Schlacks²,

Vishkautsan³

et al. 2021

Veterinary Internal Medicne

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“…In birds, the use of azoles has been more frequently studied; in Humboldt penguins ( Spheniscus humboldti ) oral itraconazole at 20 mg/kg reaches plasma concentrations of 1.4 µg/mL, being above 0.5 µg/mL, which is the minimum concentration considered effective in humans [ 53 , 54 ], but with a short terminal elimination half-life (5.06 h). Voriconazole has been tested in African penguins ( Spheniscus demersus ) orally at 5 mg/kg, obtaining a C max of 1.89 µg/mL, which is very close to the minimum effective concentration in humans (2 µg/mL) and other mammal species.…”

Section: Azole Antifungal Drugs As Treatment Of Fungal Diseases In El...mentioning

confidence: 99%

Fungal Diseases in Elasmobranchs and Their Possible Treatment with a Special Mention to Azole Antifungal Agents

Cañizares-Cooz,

García-Párraga,

Plá-González

et al. 2023

Animals

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Introduction: Elasmobranchs currently constitute an important part of the animal collection of many aquariums worldwide. Their maintenance under human care has allowed us to describe and identify new pathogens and diseases affecting them, as well as to determine different treatments for these diseases. Great advances in elasmobranch husbandry have been developed. Methods: A search was performed on scientific databases as PubMed and other specialized sources (IAAAM archive). Results: Little information on pharmacotherapeutics is available in this taxonomic group, and treatments lack a scientific base and instead are frequently dependent on empirical knowledge. Pharmacokinetic studies are the first step to determining therapeutic protocols that are safe and effective. The available bibliography shows that a majority of the mycoses recorded in cartilaginous fish are severe, aggravated by the fact that the antifungal treatments administered, following the guidelines used for teleost species, are ineffective in elasmobranchs. Azoles appear to be a promising group of antifungals for use in treating systemic mycoses in sharks and rays. Conclusions: Based on the findings of this review, it is essential to investigate the pharmacokinetics of the different antifungals in these species in order to provide therapeutic options for fungal infections in cartilaginous fish.

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“…Due to its poor solubility, oral absorption is also affected by gastric pH and the presence of food [ 86 ]. Differences in gastric pH in avians [ 20 ] could contribute to the varying absorption parameters across species, affecting bioavailability and thus the dose to be administered.…”

Section: Pharmacokinetic Variabilities In Avians and Reptilesmentioning

confidence: 99%

A Critical Review on the Dosing and Safety of Antifungals Used in Exotic Avian and Reptile Species

Visvanathan,

Lim,

Chng

et al. 2023

JoF

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Antifungals are used in exotic avian and reptile species for the treatment of fungal diseases. Dose extrapolations across species are common due to lack of species-specific pharmacological data. This may not be ideal because interspecies physiological differences may result in subtherapeutic dosing or toxicity. This critical review aims to collate existing pharmacological data to identify antifungals with the most evidence to support their safe and effective use. In the process, significant trends and gaps are also identified and discussed. An extensive search was conducted on PubMed and JSTOR, and relevant data were critically appraised. Itraconazole or voriconazole showed promising results in Japanese quails, racing pigeons and inland bearded dragons for the treatment of aspergillosis and CANV-related infections. Voriconazole neurotoxicity manifested as seizures in multiple penguins, but as lethargy or torticollis in cottonmouths. Itraconazole toxicity was predominantly hepatotoxicity, observed as liver abnormalities in inland bearded dragons and a Parson’s chameleon. Differences in formulations of itraconazole affected various absorption parameters. Non-linearities in voriconazole due to saturable metabolism and autoinduction showed opposing effects on clearance, especially in multiple-dosing regimens. These differences in pharmacokinetic parameters across species resulted in varying elimination half-lives. Terbinafine has been used in dermatomycoses, especially in reptiles, due to its keratinophilic nature, and no significant adverse events were observed. The use of fluconazole has declined due to resistance or its narrow spectrum of activity.

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Preliminary Pilot Study of Itraconazole After a Single Oral Dose of a Veterinary Formulation Solution in African Penguins (Spheniscus demersus)

Cited by 8 publications

References 16 publications

Posaconazole treatment of refractory coccidioidomycosis in dogs

Posaconazole treatment of refractory coccidioidomycosis in dogs

Fungal Diseases in Elasmobranchs and Their Possible Treatment with a Special Mention to Azole Antifungal Agents

A Critical Review on the Dosing and Safety of Antifungals Used in Exotic Avian and Reptile Species

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