FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 330:263-272 January 27, 1994 Number 4 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Amphotericin B was the treatment of choice for patients with systemic fungal disease from the time of its introduction in the late 1950s until recently¹. However, since the introduction of ketoconazole in 1981, fluconazole in 1990, and itraconazole in 1992, these antifungal azoles, which unlike amphotericin B can be given orally, have been increasingly used as therapy for the systemic mycoses. Despite the lack of direct comparisons of the efficacy of these drugs and amphotericin B in many fungal diseases, physicians have been influenced by the efficacy, safety, and ease of administration of the azoles. For many of the . . . [Full Text of this Article]

Chemistry

Mechanism of Action

Pharmacology

Spectrum of Activity and Resistance

Adverse Effects

Drug Interactions

Clinical Indications

Candidiasis

Cryptococcosis

Endemic Mycoses (Blastomycosis, Coccidioidomycosis, and Histoplasmosis)

Aspergillosis

Antifungal Prophylaxis in Patients with Neutropenia

Summary

Source Information

From the Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham School of Medicine (W.E.D.), and the Department of Pharmacy, University Hospital, University of Alabama at Birmingham (J.A.C.), Birmingham.

Address reprint requests to Dr. Dismukes at the University of Alabama at Birmingham, Division of Infectious Diseases, THT 229, Birmingham, AL 35294-0006.

References

Related Letters:

Oral Azole Drugs as Systemic Antifungal Therapy
Schutze G. E., Etzel J. V., Como J. A., Dismukes W. E.
Extract | Full Text  
N Engl J Med 1994; 330:1759-1760, Jun 16, 1994. Correspondence

This article has been cited by other articles:

• Jaroszewski, D. E., Halabi, W. J., Blair, J. E., Coakley, B. J., Wong, R. K., Parish, J. M., Vaszar, L. T., Kusne, S., Vikram, H. R., DeValeria, P. A., Lanza, L. A., Arabia, F. A. (2009). Surgery for pulmonary coccidioidomycosis: a 10-year experience.. Ann. Thorac. Surg. 88: 1765-1772 [Abstract] [Full Text]  
• Lignell, A., Lowdin, E., Cars, O., Sjolin, J. (2008). Characterization of the inhibitory effect of voriconazole on the fungicidal activity of amphotericin B against Candida albicans in an in vitro kinetic model. J Antimicrob Chemother 62: 142-148 [Abstract] [Full Text]  
• Jung, B., Kang, S. H. (2007). Chiral imine copper chloride-catalyzed enantioselective desymmetrization of 2-substituted 1,2,3-propanetriols. Proc. Natl. Acad. Sci. USA 104: 1471-1475 [Abstract] [Full Text]  
• Riggle, P. J., Kumamoto, C. A. (2006). Transcriptional Regulation of MDR1, Encoding a Drug Efflux Determinant, in Fluconazole-Resistant Candida albicans Strains through an Mcm1p Binding Site. Eukaryot Cell 5: 1957-1968 [Abstract] [Full Text]  
• Santhana Krishnan, S G, Cobbs, R K (2006). Reversible acute adrenal insufficiency caused by fluconazole in a critically ill patient.. Postgrad. Med. J. 82: e23-e23 [Abstract] [Full Text]  
• Burrows, L. L., Stark, M., Chan, C., Glukhov, E., Sinnadurai, S., Deber, C. M. (2006). Activity of novel non-amphipathic cationic antimicrobial peptides against Candida species. J Antimicrob Chemother 57: 899-907 [Abstract] [Full Text]  
• Riedl, M., Maier, C., Zettinig, G., Nowotny, P., Schima, W., Luger, A. (2006). Long term control of hypercortisolism with fluconazole: case report and in vitro studies.. Eur J Endocrinol 154: 519-524 [Abstract] [Full Text]  
• Barchiesi, F., Spreghini, E., Baldassarri, I., Marigliano, A., Arzeni, D., Giannini, D., Scalise, G. (2004). Sequential Therapy with Caspofungin and Fluconazole for Candida albicans Infection. Antimicrob. Agents Chemother. 48: 4056-4058 [Abstract] [Full Text]  
• Barchiesi, F., Spreghini, E., Maracci, M., Fothergill, A. W., Baldassarri, I., Rinaldi, M. G., Scalise, G. (2004). In Vitro Activities of Voriconazole in Combination with Three Other Antifungal Agents against Candida glabrata. Antimicrob. Agents Chemother. 48: 3317-3322 [Abstract] [Full Text]  
• Michalopoulos, A. S., Geroulanos, S., Mentzelopoulos, S. D. (2003). Determinants of Candidemia and Candidemia-Related Death in Cardiothoracic ICU Patients. Chest 124: 2244-2255 [Abstract] [Full Text]  
• Graybill, J. R., Bocanegra, R., Najvar, L. K., Hernandez, S., Larsen, R. A. (2003). Addition of Caspofungin to Fluconazole Does Not Improve Outcome in Murine Candidiasis. Antimicrob. Agents Chemother. 47: 2373-2375 [Abstract] [Full Text]  
• Somchit, N, Hassim, S M, Samsudin, S H (2002). Itraconazole and fluconazole-induced toxicity in rat hepatocytes: a comparativein vitro study. Hum Exp Toxicol 21: 43-48 [Abstract]  
• Barchiesi, F., Schimizzi, A. M., Caselli, F., Giannini, D., Camiletti, V., Fileni, B., Giacometti, A., Di Francesco, L. F., Scalise, G. (2001). Activity of the new antifungal triazole, posaconazole, against Cryptococcus neoformans. J Antimicrob Chemother 48: 769-773 [Abstract] [Full Text]  
• Natsch, S., Steeghs, M. H. M., Hekster, Y. A., Meis, J. F. G. M., van der Meer, J. W. M., Kullberg, B. J. (2001). Use of fluconazole in daily practice: still room for improvement. J Antimicrob Chemother 48: 303-310 [Abstract] [Full Text]  
• Hesse, L. M., Venkatakrishnan, K., von Moltke, L. L., Shader, R. I., Greenblatt, D. J. (2001). CYP3A4 Is the Major CYP Isoform Mediating the in Vitro Hydroxylation and Demethylation of Flunitrazepam. Drug Metab. Dispos. 29: 133-140 [Abstract] [Full Text]  
• Barchiesi, F., Schimizzi, A. M., Caselli, F., Novelli, A., Fallani, S., Giannini, D., Arzeni, D., Di Cesare, S., Di Francesco, L. F., Fortuna, M., Giacometti, A., Carle, F., Mazzei, T., Scalise, G. (2000). Interactions between Triazoles and Amphotericin B against Cryptococcus neoformans. Antimicrob. Agents Chemother. 44: 2435-2441 [Abstract] [Full Text]  
• Barchiesi, F., Calabrese, D., Sanglard, D., Falconi Di Francesco, L., Caselli, F., Giannini, D., Giacometti, A., Gavaudan, S., Scalise, G. (2000). Experimental Induction of Fluconazole Resistance in Candida tropicalis ATCC 750. Antimicrob. Agents Chemother. 44: 1578-1584 [Abstract] [Full Text]  
• Loeffler, J., Hagmeyer, L., Hebart, H., Henke, N., Schumacher, U., Einsele, H. (2000). Rapid Detection of Point Mutations by Fluorescence Resonance Energy Transfer and Probe Melting Curves in Candida Species. Clin. Chem. 46: 631-635 [Abstract] [Full Text]  
• Barchiesi, F., Arzeni, D., Fothergill, A. W., Di Francesco, L. F., Caselli, F., Rinaldi, M. G., Scalise, G. (2000). In Vitro Activities of the New Antifungal Triazole SCH 56592 against Common and Emerging Yeast Pathogens. Antimicrob. Agents Chemother. 44: 226-229 [Abstract] [Full Text]  
• Reardon, W., Smith, A., Honour, J. W, Hindmarsh, P., Das, D., Rumsby, G., Nelson, I., Malcolm, S., Adès, L., Sillence, D., Kumar, D., DeLozier-Blanchet, C., McKee, S., Kelly, T., McKeehan, W. L, Baraitser, M., Winter, R. M (2000). Evidence for digenic inheritance in some cases of Antley-Bixler syndrome?. J. Med. Genet. 37: 26-32 [Abstract] [Full Text]  
• Louie, A., Liu, W., Miller, D. A., Sucke, A. C., Liu, Q.-F., Drusano, G. L., Mayers, M., Miller, M. H. (1999). Efficacies of High-Dose Fluconazole plus Amphotericin B and High-Dose Fluconazole plus 5-Fluorocytosine versus Amphotericin B, Fluconazole, and 5-Fluorocytosine Monotherapies in Treatment of Experimental Endocarditis, Endophthalmitis, and Pyelonephritis Due to Candida albicans. Antimicrob. Agents Chemother. 43: 2831-2840 [Abstract] [Full Text]  
• Louie, A., Banerjee, P., Drusano, G. L., Shayegani, M., Miller, M. H. (1999). Interaction between Fluconazole and Amphotericin B in Mice with Systemic Infection Due to Fluconazole-Susceptible or -Resistant Strains of Candida albicans. Antimicrob. Agents Chemother. 43: 2841-2847 [Abstract] [Full Text]  
• Winston, D. J., Pakrasi, A., Busuttil, R. W. (1999). Prophylactic Fluconazole in Liver Transplant Recipients: A Randomized, Double-Blind, Placebo-Controlled Trial. ANN INTERN MED 131: 729-737 [Abstract] [Full Text]  
• Barchiesi, F., Gallo, D., Caselli, F., Di Francesco, L. F., Arzeni, D., Giacometti, A., Scalise, G. (1999). In-vitro interactions of itraconazole with flucytosine against clinical isolates of Cryptococcus neoformans. J Antimicrob Chemother 44: 65-70 [Abstract] [Full Text]  
• Yamazaki, T., Kume, H., Murase, S., Yamashita, E., Arisawa, M. (1999). Epidemiology of Visceral Mycoses: Analysis of Data in Annual of the Pathological Autopsy Cases in Japan. J. Clin. Microbiol. 37: 1732-1738 [Abstract] [Full Text]  
• Calvo, V., Borro, J. M., Morales, P., Morcillo, A., Vicente, R., Tarrazona, V., Paris, F. (1999). Antifungal Prophylaxis During the Early Postoperative Period of Lung Transplantation. Chest 115: 1301-1304 [Abstract] [Full Text]  
• Spaltmann, F., Lohrmann, E., Ziegelbauer, K. (1999). A Target-Specific Cellular Assay for Screening of Topoisomerase I Inhibitors. J Biomol Screen 4: 93-100 [Abstract]  
• Nepomuceno, I. B., Esrig, S., Moss, R. B. (1999). Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis: Role of Atopy and Response to Itraconazole. Chest 115: 364-370 [Abstract] [Full Text]  
• Sheehan, D. J., Hitchcock, C. A., Sibley, C. M. (1999). Current and Emerging Azole Antifungal Agents. Clin. Microbiol. Rev. 12: 40-79 [Abstract] [Full Text]  
• Dumaine, R., Roy, M.-L., Brown, A. M. (1998). Blockade of HERG and Kv1.5 by Ketoconazole. J. Pharmacol. Exp. Ther. 286: 727-735 [Abstract] [Full Text]  
• Radding, J. A., Heidler, S. A., Turner, W. W. (1998). Photoaffinity Analog of the Semisynthetic Echinocandin LY303366: Identification of Echinocandin Targets in Candida albicans. Antimicrob. Agents Chemother. 42: 1187-1194 [Abstract] [Full Text]  
• White, T. C., Marr, K. A., Bowden, R. A. (1998). Clinical, Cellular, and Molecular Factors That Contribute to Antifungal Drug Resistance. Clin. Microbiol. Rev. 11: 382-402 [Abstract] [Full Text]  
• Fahey, J. M., Pritchard, G. A., Moltke, L. L. v., Pratt, J. S., Grassi, J. M., Shader, R. I., Greenblatt, D. J. (1998). Effects of Ketoconazole on Triazolam Pharmacokinetics, Pharmacodynamics and Benzodiazepine Receptor Binding in Mice. J. Pharmacol. Exp. Ther. 285: 271-276 [Abstract] [Full Text]  
• Graybill, J. R., Najvar, L. K., Montalbo, E. M., Barchiesi, F. J., Luther, M. F., Rinaldi, M. G. (1998). Treatment of Histoplasmosis with MK-991 (L-743,872). Antimicrob. Agents Chemother. 42: 151-153 [Abstract] [Full Text]  
• Manfredi, R., Mastroianni, A., Coronado, O. V., Chiodo, F. (1997). Fluconazole as Prophylaxis Against Fungal Infection in Patients With Advanced HIV Infection. Arch Intern Med 157: 64-69 [Abstract]  
• Schutze, G. E., Etzel, J. V., Como, J. A., Dismukes, W. E. (1994). Oral Azole Drugs as Systemic Antifungal Therapy. NEJM 330: 1759-1760 [Full Text]