Clinical efficacy and safety of intravenous itraconazole followed by capsules in management of chronic pulmonary aspergillosis
Tekefumi Saitoa Shoji Kudob Tsuyoshi Ogurac Shigeru Kohnod Hideo Ogatab Atsuyuki Kurashimab Kenji Ogawae
aNational Hospital Organization Ibarakihigashi National Hospital
bJapan Anti-Tuberculosis Association, Fukujuji Hospital
cJapan Anti-Tuberculosis Association-Osaka
dNagasaki University School of Medicine
eNational Hospital Organization Higashi Nagoya National Hospital
We evaluated the efficacy and safety of intravenous itraconazole (ITCZ) followed by high-dose capsules in treatment for patients with chronic pulmonary aspergillosis. Sixty-seven patients were enrolled, and their overall efficacy was determined by imaging findings and clinical symptoms. The results: 59.7% (37/62), excluding 5 cases, unable to judge; 63.5% (33/52) in cases of first-line therapy with ITCZ; and 40% (4/10) in cases of second-line therapy. Adverse events affected 28 patients in 35 cases (45.2%), which were commonly gastrointestinal disorders, edema, fever, or impaired liver function. These results suggest that step-down therapy, intravenous ITCZ followed by high-dose capsules, be recommended as treatment for patients with chronic pulmonary aspergillosis.
Chronic pulmonary aspergillosis Itraconazole High-dose capsules Switching therapy
Received 11 Mar 2013 / Accepted 28 Jun 2013
AJRS, 2(6): 724-729, 2013