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Titolo:
Emergence of resistance to fluconazole as a cause of failure during treatment of histoplasmosis in patients with acquired immunodeficiency disease syndrome
Autore:
Wheat, LJ; Connolly, P; Smedema, M; Brizendine, E; Hafner, R;
Indirizzi:
Histoplasmosis Reference Lab, Indianapolis, IN 46202 USA Histoplasmosis Reference Lab Indianapolis IN USA 46202 olis, IN 46202 USA Indiana Univ, Sch Med, Indianapolis, IN USA Indiana Univ Indianapolis IN USA ana Univ, Sch Med, Indianapolis, IN USA Vet Affairs Med Ctr, Indianapolis, IN USA Vet Affairs Med Ctr Indianapolis IN USA rs Med Ctr, Indianapolis, IN USA NIAID, Div AIDS, Rockville, MD USA NIAID Rockville MD USANIAID, Div AIDS, Rockville, MD USA
Titolo Testata:
CLINICAL INFECTIOUS DISEASES
fascicolo: 11, volume: 33, anno: 2001,
pagine: 1910 - 1913
SICI:
1058-4838(200112)33:11<1910:EORTFA>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
AMPHOTERICIN-B; ITRACONAZOLE; AIDS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Wheat, LJ Histoplasmosis Reference Lab, 1001 W 10th St,OPW 430, Indianapolis, IN 46202 USA Histoplasmosis Reference Lab 1001 W 10th St,OPW 430 Indianapolis IN USA 46202
Citazione:
L.J. Wheat et al., "Emergence of resistance to fluconazole as a cause of failure during treatment of histoplasmosis in patients with acquired immunodeficiency disease syndrome", CLIN INF D, 33(11), 2001, pp. 1910-1913

Abstract

In sequential clinical trials of treatment for histoplasmosis in patients with acquired immunodeficiency syndrome, therapy with fluconazole failed ina higher proportion of patients than did therapy with itraconazole. To determine the cause for failure with fluconazole, antifungal susceptibility testing that used modified National Committee on Clinical Laboratory Standards procedures was performed on all baseline and failure isolates. Failure occurred more frequently in patients with baseline isolates with fluconazole minimum inhibitory concentrations (MICs) greater than or equal to5 mug/mL versus lower MICs; 29% versus 3%, respectively. There was at least a 4-fold increase in fluconazole MIC in the isolates from 10 (59%) of 17 patients for whom paired pretreatment and failure or relapse isolates were available. Cross-resistance to itraconazole was not seen. In conclusion, fluconazole is less active than itraconazole for Histoplasma capsulatum and induces resistance during therapy, which accounted for treatment failure in some patients.

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Documento generato il 26/09/20 alle ore 01:12:35