Therapeutic and safety evaluation of 200 mg/day itraconazole for 7 days in the treatment of recalcitrant superficial mycoses - a preliminary report

BACKGROUND/AIMS: Itraconazole is active against most human fungal pathogens and has been conventionally used in the treatment of tinea corporis/cruris at a dosage of 100 mg once daily for 15 days. Recently, a new regimen of 200 mg daily for 7 days has been shown to be equally effective, but there are no reports of the use of this new regimen in the Taiwanese population. METHODS: In this open study, 17 patients with recalcitrant superficial mycoses were given 200 mg/day itraconazole for 7 days. All of them completed the treatment and 11 patients returned for follow-up 4 weeks after the treatment. RESULTS: Cure or marked improvement at the end of the 7-day treatment period was noted in 10 of 17 patients (59) while partial improvement was noted in 7 of 17 (41). Four weeks after completion of the treatment, 9 of 11 (82) remained cured or markedly improved, 1 of 11 (9) was partially improved, and 1 of 11 (9) had relapsed. These findings were consistent with the grading of each clinical symptom of infection. Negative mycological evaluation at the end of treatment was found in 10 of 17 patients (59), and 4 weeks after the treatment it was found in 8 of 11 patients (73). Itraconazole was well tolerated in all except two patients, one of whom developed belching and the other was bothered by polyuria and impotence. Both adverse effects subsided in these patients after discontinuation of the treatment. CONCLUSION: These results suggest that shorter treatment schedules with higher doses are effective for the treatment of Taiwanese patients with recalcitrant superficial mycoses.