Oral and parenteral treatment with itraconazole in various superficial and systemic experimental fungal infections. Comparisons with other antifungals and combination therapy.

Itraconazole has been tested in vitro against 6,113 different strains of a total of 252 fungal species. Almost all medically important fungi are apparently sensitive to itraconazole. Topical and oral treatment with itraconazole was found to be successful in microsporosis, trichophytosis, vulvovaginal, gastrointestinal and systemic candidosis, pityrosporosis, sporotrichosis, histoplasmosis, aspergillosis and cryptococcosis induced in a number of animal models. Vulvovaginal candidosis responded well to itraconazole, with a one-day topical or oral treatment resulting in a complete cure. The same results could not be achieved with the same concentration or dosage of either ketoconazole or fluconazole. Biologically active antifungal levels were present in plasma and vaginal fluid of rats after one dose of itraconazole 10 mg/kg for at least 72 hours. Itraconazole was also found to be successful in immunodepressed animals infected with a number of different diseases and in disseminated and systemic infections, such as candidosis, aspergillosis and cryptococcosis. Oral and parenteral itraconazole treatment was compared with oral and parenteral fluconazole treatment and parenteral amphotericin B in a number of models. Results overall were better with itraconazole. Combination therapy of itraconazole with fluconazole was not found to be superior to treatment with itraconazole alone. No side-effects were observed with itraconazole treatment.