Galgiani J N, Stevens D A, Graybill J R, Dismukes W E, Cloud G A
Medical Service, Veterans Administration Medical Center, Tucson, Arizona 85723.
Am J Med. 1988 Mar;84(3 Pt 2):603-10. doi: 10.1016/0002-9343(88)90143-x.
One hundred and twelve patients with progressive pulmonary, skeletal, or soft tissue infections caused by Coccidioides immitis were randomly assigned to treatment with 400 or 800 mg per day dosages of ketoconazole. During therapy, if response was unsatisfactory, the protocol provided for treatment with higher doses. With 400 mg, ketoconazole resulted in 23.2 percent successes, which was similar to 32.1 percent successes with 800-mg treatments (p = 0.29). An additional six of 23 patients in whom initial therapy failed and who later received 1,200 or 1,600 mg per day of ketoconazole also showed improvement. However, among patients completing successful courses of therapy, relapses were more frequent in those requiring higher than 400-mg dosages for their success. From these studies, it is concluded that ketoconazole in doses above those currently recommended offer little or no benefit for most patients with non-meningeal forms of coccidioidomycosis.
112例由粗球孢子菌引起的进行性肺部、骨骼或软组织感染患者被随机分配接受每日400毫克或800毫克剂量的酮康唑治疗。在治疗期间，如果反应不令人满意，方案规定使用更高剂量进行治疗。使用400毫克时，酮康唑的成功率为23.2%，这与800毫克治疗的32.1%成功率相似（p = 0.29）。最初治疗失败且后来接受每日1200毫克或1600毫克酮康唑治疗的23例患者中，另有6例也有改善。然而，在完成成功治疗疗程的患者中，那些成功需要高于400毫克剂量的患者复发更为频繁。从这些研究得出结论，对于大多数非脑膜型球孢子菌病患者，高于目前推荐剂量的酮康唑几乎没有益处。
