Ketoconazole treatment of coccidioidal meningitis

J. R. Graybill, D. A. Stevens, John N Galgiani, A. M. Sugar, P. C. Craven, C. Gregg, M. Huppert, G. Cloud, W. E. Dismukes

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Fifteen patients with coccidioidal meningitis were treated with high doses of ketoconazole for up to 4 years. Five patients were treated with ketoconazole alone. One clinically failed, one developed hepatotoxicity, and three achieved remission of meningitis. One patient received intrathecal AMB in addition to ketoconazole for only 2 weeks before continuing on ketoconazole alone. He improved, but discontinued ketoconazole because of nausea and vomiting, and suffered a lethal relapse. Nine patients received ketoconazole in combination with prolonged courses of intrathecal AMB. Two patients were failures from nausea and vomiting, and the remaining seven either improved or experienced remission. The clinical responses appeared to be similar in patients receiving high-dose ketoconazole, either alone or combined with AMB, suggesting that there is no clinically significant antagonism of the drug. Nausea and vomiting are significant limitations of high-dose ketoconazole. Ketoconazole alone is effective in some patients with coccidioidomycotic meningitis.

Original languageEnglish (US)
Pages (from-to)488-496
Number of pages9
JournalAnnals of the New York Academy of Sciences
Volume544
StatePublished - 1988
Externally publishedYes

Fingerprint

Ketoconazole
Meningitis
Nausea
Vomiting
Therapeutics
Drug Antagonism
Recurrence
Dose

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Graybill, J. R., Stevens, D. A., Galgiani, J. N., Sugar, A. M., Craven, P. C., Gregg, C., ... Dismukes, W. E. (1988). Ketoconazole treatment of coccidioidal meningitis. Annals of the New York Academy of Sciences, 544, 488-496.

Ketoconazole treatment of coccidioidal meningitis. / Graybill, J. R.; Stevens, D. A.; Galgiani, John N; Sugar, A. M.; Craven, P. C.; Gregg, C.; Huppert, M.; Cloud, G.; Dismukes, W. E.

In: Annals of the New York Academy of Sciences, Vol. 544, 1988, p. 488-496.

Research output: Contribution to journalArticle

Graybill, JR, Stevens, DA, Galgiani, JN, Sugar, AM, Craven, PC, Gregg, C, Huppert, M, Cloud, G & Dismukes, WE 1988, 'Ketoconazole treatment of coccidioidal meningitis', Annals of the New York Academy of Sciences, vol. 544, pp. 488-496.
Graybill JR, Stevens DA, Galgiani JN, Sugar AM, Craven PC, Gregg C et al. Ketoconazole treatment of coccidioidal meningitis. Annals of the New York Academy of Sciences. 1988;544:488-496.
Graybill, J. R. ; Stevens, D. A. ; Galgiani, John N ; Sugar, A. M. ; Craven, P. C. ; Gregg, C. ; Huppert, M. ; Cloud, G. ; Dismukes, W. E. / Ketoconazole treatment of coccidioidal meningitis. In: Annals of the New York Academy of Sciences. 1988 ; Vol. 544. pp. 488-496.
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AU - Huppert, M.

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