Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis.
BACKGROUND: There are no published reports on studies comparing itraconazole (ITC), sulfamethoxazole-trimethoprim (cotrimoxazole, CMX), and ITC followed by CMX (ITC/CMX) in the treatment of paracoccidiodomycosis. This study aimed to compare the efficacy, effectiveness, safety and time to clinical an...
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ftdoajarticles:oai:doaj.org/article:318157acebe041e98f3a4b774c17a4e5 2023-05-15T15:16:18+02:00 Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. Ricardo de Souza Cavalcante Tatiane Fernanda Sylvestre Adriele Dandara Levorato Lídia Rachel de Carvalho Rinaldo Poncio Mendes 2014-04-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002793 https://doaj.org/article/318157acebe041e98f3a4b774c17a4e5 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3990481?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002793 https://doaj.org/article/318157acebe041e98f3a4b774c17a4e5 PLoS Neglected Tropical Diseases, Vol 8, Iss 4, p e2793 (2014) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2014 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002793 2022-12-31T12:10:17Z BACKGROUND: There are no published reports on studies comparing itraconazole (ITC), sulfamethoxazole-trimethoprim (cotrimoxazole, CMX), and ITC followed by CMX (ITC/CMX) in the treatment of paracoccidiodomycosis. This study aimed to compare the efficacy, effectiveness, safety and time to clinical and serologic cure in paracoccidioidomycosis patients treated with ITC or CMX, the antifungal agents most widely used. METHODOLOGY: A quasi-experimental study was performed in 177 patients with a confirmed or probable diagnosis of paracoccidioidomycosis. Treatment was divided into two stages: 1) initial, which was continued until clinical cure was achieved and the erythrocyte sedimentation rate decreased to normal values; 2) complementary, which was continued until serologic cure was achieved. Medians were compared via the Mann-Whitney test, and frequencies were compared via the chi-squared test. The assessment of variables as a function of time was performed using Kaplan-Meier curves and Cox regression. The significance level was established as p≤0.05. PRINCIPAL FINDINGS: No difference was found in the efficacy and effectiveness of the initial treatment of 47 individuals given ITC and 130 individuals given CMX; however, the time to clinical cure was shorter in the former compared with the latter group (105 vs. 159 days; p = 0.001), specifically in patients with the chronic form. Efficacy and effectiveness of the three regimens were similar in the complementary treatment; however, the time to serologic cure was shorter when ITC (161 days) or CMX (495 days) was used compared with ITC/CMX (881 days) [p = 0.02]. The independent predictors of a shorter time to serologic cure were treatment with ITC [risk ratio = 6.61 (2.01-21.75)] or with CMX [risk ratio = 5.11 (1.91-13.67)]). The prevalence of side effects was lower with ITC (6.4%) than with CMX (20.0%; p = 0.03). CONCLUSIONS: Since ITC induced earlier clinical cure and was better tolerated than CMX, such triazole should be considered the first-choice for PCM treatment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) PLoS Neglected Tropical Diseases 8 4 e2793 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ricardo de Souza Cavalcante Tatiane Fernanda Sylvestre Adriele Dandara Levorato Lídia Rachel de Carvalho Rinaldo Poncio Mendes Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: There are no published reports on studies comparing itraconazole (ITC), sulfamethoxazole-trimethoprim (cotrimoxazole, CMX), and ITC followed by CMX (ITC/CMX) in the treatment of paracoccidiodomycosis. This study aimed to compare the efficacy, effectiveness, safety and time to clinical and serologic cure in paracoccidioidomycosis patients treated with ITC or CMX, the antifungal agents most widely used. METHODOLOGY: A quasi-experimental study was performed in 177 patients with a confirmed or probable diagnosis of paracoccidioidomycosis. Treatment was divided into two stages: 1) initial, which was continued until clinical cure was achieved and the erythrocyte sedimentation rate decreased to normal values; 2) complementary, which was continued until serologic cure was achieved. Medians were compared via the Mann-Whitney test, and frequencies were compared via the chi-squared test. The assessment of variables as a function of time was performed using Kaplan-Meier curves and Cox regression. The significance level was established as p≤0.05. PRINCIPAL FINDINGS: No difference was found in the efficacy and effectiveness of the initial treatment of 47 individuals given ITC and 130 individuals given CMX; however, the time to clinical cure was shorter in the former compared with the latter group (105 vs. 159 days; p = 0.001), specifically in patients with the chronic form. Efficacy and effectiveness of the three regimens were similar in the complementary treatment; however, the time to serologic cure was shorter when ITC (161 days) or CMX (495 days) was used compared with ITC/CMX (881 days) [p = 0.02]. The independent predictors of a shorter time to serologic cure were treatment with ITC [risk ratio = 6.61 (2.01-21.75)] or with CMX [risk ratio = 5.11 (1.91-13.67)]). The prevalence of side effects was lower with ITC (6.4%) than with CMX (20.0%; p = 0.03). CONCLUSIONS: Since ITC induced earlier clinical cure and was better tolerated than CMX, such triazole should be considered the first-choice for PCM treatment. |
format |
Article in Journal/Newspaper |
author |
Ricardo de Souza Cavalcante Tatiane Fernanda Sylvestre Adriele Dandara Levorato Lídia Rachel de Carvalho Rinaldo Poncio Mendes |
author_facet |
Ricardo de Souza Cavalcante Tatiane Fernanda Sylvestre Adriele Dandara Levorato Lídia Rachel de Carvalho Rinaldo Poncio Mendes |
author_sort |
Ricardo de Souza Cavalcante |
title |
Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
title_short |
Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
title_full |
Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
title_fullStr |
Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
title_full_unstemmed |
Comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
title_sort |
comparison between itraconazole and cotrimoxazole in the treatment of paracoccidiodomycosis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2014 |
url |
https://doi.org/10.1371/journal.pntd.0002793 https://doaj.org/article/318157acebe041e98f3a4b774c17a4e5 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Arctic Meier |
geographic_facet |
Arctic Meier |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 8, Iss 4, p e2793 (2014) |
op_relation |
http://europepmc.org/articles/PMC3990481?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002793 https://doaj.org/article/318157acebe041e98f3a4b774c17a4e5 |
op_doi |
https://doi.org/10.1371/journal.pntd.0002793 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
8 |
container_issue |
4 |
container_start_page |
e2793 |
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1766346585815384064 |