[A clinical study of fluconazole in pulmonary aspergillosis].

Fluconazole is a novel triazole antifungal agent. Its in vitro antifungal activity against Aspergillus spp. is rather weak, but in vivo animal protection studies in mice with Aspergillus infections showed that the activity of fluconazole was about 15 times as potent as that of ketoconazole. We have studied the clinical efficacy and the safety of fluconazole given to 6 patients with chronic intractable respiratory disease, pulmonary aspergillosis, at an oral dose of 400 mg once daily for 23 days to 110 days (70 days on the average). Patients were selected from those who fulfilled 2 of the following 3 criteria: 1) those with chest X-ray evidence of fungus ball, 2) those from whom Aspergillus was continuously isolated through culture of their sputum, 3) those with evidence of serum precipitinogen against Aspergillus. Clinical efficacies were good in 2 patients out of 6 with marked contraction of fungus balls, fair in 2 with slight contraction of fungus balls or improvement of clinical symptoms, and failed in 2. Side effects and laboratory parameter abnormalities possibly considered to be related to fluconazole were not observed in any of the patients enrolled in the study, suggesting the safety in a long-term usage of the drug.