Clinical study of miconazole in deep-seated mycoses with evaluation of serological diagnosis

Shigeru Kohno, Kohtaro Mitsutake, Tetsuhiro Noda, Haruko Matsuda, Shigefumi Maesaki, Akira Yasuoka, Mitsuo Kaku, Hironobu Koga, Kohei Hara, Iwamoto Masanori, Inoue Yuichi, Toru Ishino, Kiyo Fujita, Masao Nakatomi, Osamu Sakito, Naomi Ito, Kazuo Sasayama, Masamoto Nakano, Kenji Irifune, Koichi WatanabeTakeshi Ishizaki, Makiko Seto, Genichiro Mameya, Kenichi Tanaka, Touru Fujino, Hiroshi Yamada, Hideo Mashimoto, Naofumi Suyama, Jun Araki, Sadahiro Asai, Tatsuya Katsumata, Rokushi Oka, Akira Sakamoto, Takashige Miyazaki, Kiyoyasu Fukuhima, Kazuhiro Okuno, Masahiro Yatsugi, Miyako Ishiguro, Tetsuro Kanda, Toshiyuki Oe

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Sixty three cases of deep-seated mycosis, mainly complications of diseases of the central nervous system or lung, were treated with daily doses of 800–1,200 mg of miconazole for 20.1 ±12.2 days. Mycological eradication rates were 50% (9 of 18) for confirmed cases of deep-seated mycosis, and 66.7% (6 of 9) for candidemia. Clinical response rates were 61.9% (13 of 21) for confirmed cases of deep-seated mycosis and 90% (9 of 10) for candidemia. Side effects, including abdominal symptoms in 10 cases, of miconazole were observed in 11 of 63 cases (17.5%). Abnormal laboratory data, such as liver dysfunction in 3 cases, were observed in 6 of 63 cases (9.5%). Sero-diagnostic methods for deep-seated mycoses were studied. To measure the fungal index mean beta-glucan, we used the endotoxin test D minus endospecy, with positive results of greater than 60 pg/ml in 7 of 11 cases (63.6%) of candidemia. Cand-Tec titers of more than 4 × were seen in 7 of 10 cases (70%), and mannnan was positive in 6 of 10 cases (60%). However, a D-arabinitol/creatinine ratio of more than 2.0 was seen in only 2 of 7 cases. In pulmonary aspergillosis, anti-aspergillus antibody was positive in 3 of 4 cases. In pulmonary cryptococcosis, capsular antigen was positive in 3 of 4 cases. These data suggest that a combination of various serodiagnostic methods is useful for diagnosing in deep-seated mycoses.

Original languageEnglish
Pages (from-to)638-646
Number of pages9
JournalChemotherapy
Volume40
Issue number5
DOIs
Publication statusPublished - 1992 May
Externally publishedYes

Keywords

  • miconazole

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases
  • Pharmacology
  • Drug Discovery
  • Oncology

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