Document 0485
 DOCN  M9610485
 TI    Therapy for opportunistic fungal infections: past, present and future.
 DT    9601
 AU    Stevens DA; Department of Medicine, Santa Clara Valley Medical Centre,;
       Stanford University Medical School, San Jose, California; 95128-2699,
       USA.
 SO    Indian J Cancer. 1995 Mar;32(1):1-9. Unique Identifier : AIDSLINE
       MED/96038073
 AB    The field of antifungal chemotherapy is presently rapidly moving. It
       began in 1903, with the successful use of potassium iodide (KI). Then
       there was little progress for 50 years, when in 1951, nystatin was
       introduced, the first useful polyene. Four years later amphotericin B
       followed, which is still the historical standard against which new
       systemic antifungals are compared. Except for the development of
       flucytosine, there was little progress until the early 1970s and the
       development of the azole drugs. The present era, which is characterized
       largely by the modifications of azole drugs, began with ketoconazole and
       brought agents which can be given orally and have increasing potency,
       decreasing toxicity and a broader spectrum of activity. Recent studies
       have examined ways to ameliorate the well-known toxicities of
       amphotericin B. A new approach has been to complex the drug with lipids
       or entrap it in liposomes. Itraconazole is a broad-spectrum oral
       triazole whose greatest advantages over the imidazoles are in its
       activity against aspergillosis and cryptococcosis, though it is also
       efficacious against the endemic deep mycoses. Fluconazole is a
       broad-spectrum triazole. It has been shown to be efficacious in various
       forms of superficial candidosis, including esophageal disease. We have
       shown in a randomized, double-blind, placebo-controlled study that
       maintenance therapy can completely prevent thrush in AIDS patients with
       recurrent thrush and possibly prevent all deep and superficial mycoses.
       Other studies have shown efficacy in cryptococcal meningitis in AIDS
       comparable to conventional therapy and with far less toxicity, and also
       in prevention of relapse of cryptococcal disease. Early diagnosis of
       fungal infections in cancer patients is problematic.(ABSTRACT TRUNCATED
       AT 250 WORDS)
 DE    Acquired Immunodeficiency Syndrome/MICROBIOLOGY  Antifungal
       Agents/*THERAPEUTIC USE  AIDS-Related Opportunistic Infections/DRUG
       THERAPY  Drug Therapy/TRENDS  Human  Mycoses/*DRUG THERAPY
       Opportunistic Infections/*DRUG THERAPY  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

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