Itraconazole vs. trimethoprim-sulfamethoxazole: A comparative cohort study of 200 patients with paracoccidioidomycosis
| Autor: | Bodo Wanke, Mayara da Costa Chambela, Gilberto Marcelo Sperandio da Silva, Raquel de Vasconcellos Carvalhaes de Oliveira, Regina Lana Braga Costa, Antonio Carlos Francesconi do Valle, Sheila Rocha Conceição Borges |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents Adolescent Itraconazole Pharmacology law.invention Cohort Studies Young Adult Randomized controlled trial law Internal medicine Trimethoprim Sulfamethoxazole Drug Combination Medicine Humans Aged Retrospective Studies Aged 80 and over business.industry Paracoccidioidomycosis Sulfamethoxazole Incidence (epidemiology) Retrospective cohort study General Medicine Middle Aged medicine.disease Trimethoprim Infectious Diseases Treatment Outcome Female business Brazil medicine.drug Cohort study |
| Zdroj: | Medical mycology. 52(3) |
| ISSN: | 1460-2709 |
| Popis: | Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America. Brazil accounts for approximately 80% of cases, where it represents a major public health issue due to its disabling impact and the number of premature deaths it causes. We present a retrospective cohort study that was conducted in order to better understand factors that relate to cure of the infection in the treatment of 200 patients with PCM. We evaluated the influence of sociodemographic and clinical factors as well as therapeutic regimen (trimethoprim-sulfamethoxazole [TMP-SMX] and itraconazole) on the progress of PCM (cure and noncure). There was a higher incidence of cure (83%) among patients who regularly received treatment for their infections and completed the treatment protocol. Moreover, itraconazole (86.4%) was significantly superior to TMP-SMX (51.3%) in terms of cure rate and had a median treatment period that was significantly shorter (12 months) than that for TMP-SMX (23 months). A Cox proportional hazard regression model showed that use of itraconazole increased the hazard of cure, regardless of sex, age, education, clinical form, completion of treatment, and regularity. Although the results of this study show that itraconazole was the best treatment option for PCM patients, a double-blind, randomized, controlled trial is necessary to confirm this conclusion. |
| Databáze: | OpenAIRE |
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