Treatment of human cutaneous sporotrichosis with itraconazole

Abstract

Summary. Eighteen adult white male patients with cutaneous sporotrichosis were treated with itraconazole following different daily dose schemes. Cure was obtained in all cases after periods of 15–75 days (median 44 days) with total doses between 3.1 and 14.8 g (median 8.4 g). No serious side effects were observed and no relapses occurred in the follow‐up period of between 1 and 26 months (median 14.7). These results show that itraconazole represents a safe and effective drug for the treatment of sporotrichosis. Comparison with other studies leads us to consider a daily dose of 200 mg as the most appropriate. A concomitant warming of the affected limbs should be recommended. Zusammenfassung. Achtzehn männliche Erwachsene weißer Hautfarbe mit kutaner Sporotrichose wurden nach unterschiedlichen Dosierungsschemata mit Itraconazol behandelt. Eine Heilung wurde in allen Fällen nach einer Behandlungsdauer zwischen 15 und 75 d (Mittel 44 d) mit Gesamtdosen von 3.1 bis 14.8 g (Mittel 8.4 g) erzielt. Bedeutsame Nebenwirkungen wurden nicht beobachtet. In der Nachbeobachtungszeit, die mit einem Mittel von 14.7 Monaten zwischen einem und 26 Monaten lag, traten keine Rück‐fälle auf. Die Ergebnisse belegen, daß Itraconazol ein sicher wirksames Medikament für die Behandlung der Sporotrichose darstellt. Unter Einbeziehung der Ergebnisse anderer Studien erscheint uns eine tägliche Itraconazol‐Dosis von 200 mg als am günstigsten. Eine gleichzeitige Erwärmung der befallenen Gliedmaßen wird empfohlen.

Clinical Practice Guidelines for the Management of Sporotrichosis: 2007 Update by the Infectious Diseases Society of America

“…For cutaneous and lymphocutaneous infections, response rates of 90%-100% were noted with itraconazole therapy [18,39,40], compared with a 63%-71% response rate associated with fluconazole therapy [20,41]. Osteoarticular infections respond less well.…”

“…Evidence summary. Open treatment trials of itraconazole administered at a dosage of 100-200 mg orally daily for 2-9 months have shown success rates of 90%-100% without significant adverse events [18,39,40]. Clinical improvement is often manifested within 4 weeks after starting therapy, and only a small number of patients need higher dosages of itraconazole or therapy with other antifungals.…”

Diagnosis of Aging Skin Diseases

“…Itraconazole is the drug of choice for lymphocutaneous sporotrichosis [76]. This may be substituted with fluconazole in patients unable to tolerate side effects.…”

A Rose by Any Other Name

“…Itraconazole is the drug of choice for the treatment of lymphocutaneous sporotrichosis, as well as less severe cases of osteoarticular and pulmonary disease 7,8 . Response rates are >90% with the administration of 100‐ to 200‐mg itraconazole daily for 3 to 6 months.…”