Ketoconazole: A Major Innovation for Treatment of Fungal Disease
Authors: JOHN R. GRAYBILL
Journal: Annals of Internal Medicine (1980)

Editorials1 December 1980Ketoconazole: A Major Innovation for Treatment of Fungal DiseaseJOHN R. GRAYBILL, M.D., DAVID J. DRUTZ, M.D.JOHN R. GRAYBILL, M.D.Search for more papers by this author, DAVID J. DRUTZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-6-921 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTreatment of systemic mycotic infections currently requires amphotericin B, miconazole, or flucytosine. All three agents have significant toxicity, and both amphotericin B and miconazole must be given intravenously, usually in a hospital setting. Flucytosine has a limited spectrum of activity, and the development of drug resistance by Candida and cryptococcal species is well documented. All three of these drugs have been the subjects of recent reviews (1-3).There has been no generally available antifungal agent that is orally absorbable, nontoxic, and effective against etiologic agents of systemic mycoses. However, there is now in clinical trials an imidazole derivative that may...References1. SAROSIARMSTRONGBARBEE GDR. Treatment of fungal disease. American Thoracic Society Medical Section of the American Lung Association. Am Rev Respir Dis. 1979;120:1393-7. MedlineGoogle Scholar2. MEDOFFKOBAYASHI GG. Strategies in the treatment of systemic fungal infections. N Engl J Med. 1980;302:145-55. CrossrefMedlineGoogle Scholar3. STEVENS D. Miconazole in the treatment of systemic fungal infections Am Rev Respir Dis. 1978;116:801-6. Editorial. Google Scholar4. HEELBROGDENPAKESSPEIGHTAVERY RRCTG. Miconazole: a preliminary review of its therapeutic efficacy in systemic fungal infections. Drugs. 1980;19:7-30. CrossrefMedlineGoogle Scholar5. BORGERSJANSSEN MP. The imidazole antifungals: their properties and activities with special reference to ketoconazole: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. Google Scholar6. DIXONSHADOMYSHADOMYESPINEL-INGROFFKERKERING DSHAT. Comparison of the in vitro antifungal activities of miconazole and a new imidazole, R41.400. J Infect Dis. 1978;138:245-8. CrossrefMedlineGoogle Scholar7. LEVINECOBB HJ. Oral therapy for experimental coccidioidomycosis with R41 400 (ketoconazole), a new imidazole. Am Rev Respir Dis. 1978;118:715-21. CrossrefMedlineGoogle Scholar8. LEVINECOBB HJ. Ketoconazole in early and late murine coccidioidomycosis: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefGoogle Scholar9. HARVEYISENBERTSTEVENS RRD. Molecular modification of imidazole compounds: in vitro activity, synergism studies, pharmacology, therapy in a murine blastomycosis model: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefGoogle Scholar10. HATALAMODRLISKA MZM. Oral treatment of experimental candidiasis with R41,400 (ketoconazole). In: NELSON JD, GRASSI C, eds. Current Chemotherapy and Infectious Disease—Proceedings of the 11th International Conference of Chemotherapy and the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington: American Society for Microbiology; 1980;962-3. Google Scholar11. WILLIAMSGRAYBILLDRUTZLEVINE DJDH. Suppression of cryptococcosis and histoplasmosis by ketoconazole in athymic nude mice. J Infect Dis. 1980;141:76-80. CrossrefMedlineGoogle Scholar12. SYMOENSMOENSDOM JMJ. An evaluation of two years of clinical experience with ketoconazole: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefMedlineGoogle Scholar13 BORELLIBRANFUENTES DJJ. Ketoconazole, an oral antifungal: laboratory and clinical assessment of imidazole drugs. Postgrad Med J. 1979;55:657-61. CrossrefMedlineGoogle Scholar14. GRAYBILLLUNDBERGDONOVANLEVINERODRIGUEZDRUTZ JDWHMD. Treatment of coccidioidomycosis with ketoconazole: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. Google Scholar15. BURGESSBODEY MG. Clotrimazole (Bay b 5097): in vitro and clinical pharmacologic studies. Antimicrob Agents Chemother. 1972;2:423-6. CrossrefMedlineGoogle Scholar16. ROSENBLATTBYRNEAMENTSTIEHM HWME. Successful treatment of severe chronic mucocutaneous candidiasis with a new oral agent, ketoconazole (R41,400). See Reference 10, pp. 963-5. Google Scholar17. GRAYBILLHERNDONKNIKERLEVINE JJWH. Ketoconazole treatment of chronic mucocutaneous candidiasis. Arch Dermatol. 1980; in press. CrossrefMedlineGoogle Scholar18. PETERSENALLINGKIRKPATRICK EDC. Treatment of chronic mucocutaneous candidiasis with ketoconazole: a controlled clinical trial. Ann Intern Med. 1980;93:791-5. LinkGoogle Scholar19. BRASSGALGIANICAMPBELLSTEVENS CJSD. Therapy of coccidioidomycosis with ketoconazole: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. MedlineGoogle Scholar20. NEGRONIGONZALEZ-MONTANERPALMA-BELTRANTUCULETREY RLOMD. Ketoconazole (R41,400) in the treatment of paracoccidioidomycosis and histoplasmosis: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefGoogle Scholar21. RESTREPOSTEVENSLEIDERMAN ADE. Ketoconazole in paracoccidioidomycosis: efficacy of prolonged oral treatment: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. MedlineGoogle Scholar22. CUCEWROCLAWSKISAMPAIO LES. Treatment of paracoccidioidomycosis, candidiasis, chromomycosis, lobomycosis, and mycetoma with ketoconazole: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefMedlineGoogle Scholar23. ROBERTSONHANIFINPARKER MJF. Oral ketoconazole therapy for dermatophyte infections unresponsive to griseofulvin: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefMedlineGoogle Scholar24. LEGENDRESTELTZ RM. A multi-center double-blind comparison of ketoconazole and griseofulvin in the treatment of dermatophyte infections: Proceedings of 1st International Symposium on Ketoconazole, Medellin, Colombia. Rev Infect Dis. 1980; in press. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Audie L. Murphy Memorial Veterans' Hospital Department of Medicine University of Texas Health Science Center San Antonio, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySecond-Line Hormonal for Castrate-Resistant Prostate CancerThe Rise and Fall of Oral KetoconazoleDrug ReactionsManagement of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical CarcinomaEndocrine ToxicologyTreatment and experimental therapeutics of blastomycosisFine Feathered FriendsEffects of ketoconazole on cholesterol precursors and low density lipoprotein kinetics in hypercholesterolemia.Ketoconazole in the treatment of cryptococcosis of the central nervous systemThe antioxidant action of ketoconazole and related azoles: Comparison with tamoxifen and cholesterolEvaluation of clinical and hormonal effects in hirsute women treated with ketoconazoleDisseminated histoplasmosis with embolic endovascular complications: A case reportCutaneous CryptococcosisAdverse reactions of imidazole antifungal agents: Computer graphic studies of cytochrome P-450 interactionsLate Dissemination of PulmonaryPreliminary pharmacokinetics of ketoconazole in gopher tortoises (Gopherus polyphemus)Aminoglutethimide and ketoconazole: Historical perspectives and future prospectsCholesterol metabolism during ketoconazole treatment in man.Effects of ketoconazole on cholesterol synthesis and precursor concentrations in the rat liverThe Use of Ketoconazole as an Inhibitor of Steroid ProductionLocalized cutaneous cryptococcosis successfully treated with ketoconazoleThe endocrine effects of ketoconazoleCase Report: Refractory Esophageal Candidiasis Associated with a Low Molecular Weight Plasma Inhibitor of T-Lymphocyte FunctionUse of Gonadotropic Hormones and Sex Steroids in Assessing Male ReproductionKetoconazole Therapy for Endemic BlastomycosisROBERT W. BRADSHER, M.D., DAN C. RICE, M.D., ROBERT S. ABERNATHY, M.D.Dermatologic FormularyKetoconazole; Mechanism of Action, Spectrum of Activity, Pharmacokinetics, Drug Interactions, Adverse Reactions and Therapeutic UseManagement of the Immunocompromised HostHepatic Injury Associated With Ketoconazole TherapyBroth dilution and disc diffusion methods in the susceptibility testing of pathogenic Candida albicans against four antimycoticsChronic mucocutaneous candidiasisCandida esophagitisSevere hepatitis during ketoconazole therapyTreatment of Systemic Mycoses with Ketoconazole: Emphasis on Toxicity and Clinical Response in 52 Patients National Institute of Allergy and Infectious Diseases Collaborative Antifungal StudyWILLIAM E. DISMUKES, M.D., ALAN M. STAMM, M.D., JOHN R. GRAYBILL, M.D., PHILIP C. CRAVEN, M.D., DAVID A. STEVENS, M.D., ROBERT L. STILLER, M.D., GEORGE A. SAROSI, M.D., GERALD MEDOFF, M.D., CLARK R. GREGG, M.D., HARRY A. GALLIS, M.D., BRANCH T. FIELDS Jr., M.D., ROBERT L. MARIER, M.D., THOMAS A. KERKERING, M.D., LISA G. KAPLOWITZ, M.D., GRETCHEN CLOUD, M.S., CYNDI BOWLES, R.N., SMITH SHADOMY, Ph.D.Diagnosis and Treatment of Acquired Immune Deficiency States and Opportunistic InfectionsLaboratory and clinical assessment of ketoconazole in deep-seated mycosesOral Antimicrobial DrugsToxicity of amphotericin B, miconazole, and ketoconazole to human granulocyte progenitor cells in vitroInfectious Diseases: An Annotated Bibliography of Recent Literature References to Journal Articles and Other PapersKetoconazole and gynecomastiaRESISTANCE TO KETOCONAZOLEDermatologic therapy: December, 1980, through November, 1981New antifungal agentsRenal Pelvic Filling Defect in a Diabetic WomanChapter 15 Antifungal ChemotherapyBlastomycosisProgressive Disseminated Histoplasmosis: Favorable Response to KetoconazoleSTEPHEN S. HAWKINS, M.D., DAVID W. GREGORY, M.D., ROBERT H. ALFORD, M.D.Heterogeneity of action of mechanisms among antimycotic imidazolesGynecomastia with Ketoconazole 1 December 1980Volume 93, Issue 6Page: 921-923KeywordsAmphotericinClinical trialsDrugsFungal diseasesHealth services researchImidazoleInfectious diseasesSystemic mycosesToxic agentsToxicity Issue Published: 1 December 1980 PDF downloadLoading ...