Blastomycosis, systemic, treatment

Indications Treatment of the following systemic fungal infections Candidiasis Chronic mucocutaneous candidiasis Oral thrush Candiduria Blastomycosis Coccidioidomycosis Histoplasmosis Chromomycosis Paracoccidioidomycosis... 

Systemic fungal diseases (e.g. histoplasmosis and blastomycosis) are uncommon but, if untreated, often fatal. They usually take the form of lung infections or meningitis. The best treatment is still the polyene antibiotic, amphotericin B 5.14) whose mode of action is described in Section 5.4.1 (p. 192). It is usually administered intravenously. Flucytosine 4.23) is an excellent synergist (Section 4.0, p. 131), seldom given alone. Intravenous miconazole 6.23) provides alternative therapy, but there are frequent adverse reactions. An orally active analogue, ketoconazole ( Nizoral ) was introduced in 1981, and looks promising. 

Clinical Experience - Amphotericin B continued to be the drug of choice in treatment of serious or systemic fungal infections. It was reported earlier that while either 2-hydroxystilbamidine or amphotericin B was effective in treatment of noncavltary pulmonary blastomycosis, the latter drug was the more effective agent in treatment of this infection in those cases with cavitary disease or with systemic organ involvement.Amphotericin B also was described as useful in the treatment of canine blastomycosis. 

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