PMID- 24577007
OWN - NLM
STAT- MEDLINE
DCOM- 20141118
LR  - 20220311
IS  - 1460-2709 (Electronic)
IS  - 1369-3786 (Linking)
VI  - 52
IP  - 3
DP  - 2014 Apr
TI  - Itraconazole vs. trimethoprim-sulfamethoxazole: A comparative cohort study of 200 
      patients with paracoccidioidomycosis.
PG  - 303-10
LID - 10.1093/mmy/myt012 [doi]
AB  - Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America. 
      Brazil accounts for approximately 80% of cases, where it represents a major 
      public health issue due to its disabling impact and the number of premature 
      deaths it causes. We present a retrospective cohort study that was conducted in 
      order to better understand factors that relate to cure of the infection in the 
      treatment of 200 patients with PCM. We evaluated the influence of 
      sociodemographic and clinical factors as well as therapeutic regimen 
      (trimethoprim-sulfamethoxazole [TMP-SMX] and itraconazole) on the progress of PCM 
      (cure and noncure). There was a higher incidence of cure (83%) among patients who 
      regularly received treatment for their infections and completed the treatment 
      protocol. Moreover, itraconazole (86.4%) was significantly superior to TMP-SMX 
      (51.3%) in terms of cure rate and had a median treatment period that was 
      significantly shorter (12 months) than that for TMP-SMX (23 months). A Cox 
      proportional hazard regression model showed that use of itraconazole increased 
      the hazard of cure, regardless of sex, age, education, clinical form, completion 
      of treatment, and regularity. Although the results of this study show that 
      itraconazole was the best treatment option for PCM patients, a double-blind, 
      randomized, controlled trial is necessary to confirm this conclusion.
FAU - Borges, Sheila Rocha Conceicao
AU  - Borges SR
AD  - Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de 
      Janeiro, Brazil.
FAU - Silva, Gilberto Marcelo Sperandio da
AU  - Silva GM
FAU - Chambela, Mayara da Costa
AU  - Chambela Mda C
FAU - Oliveira, Raquel de Vasconcellos C de
AU  - Oliveira Rde V
FAU - Costa, Regina Lana Braga
AU  - Costa RL
FAU - Wanke, Bodo
AU  - Wanke B
FAU - Valle, Antonio Carlos Francesconi do
AU  - Valle AC
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140127
PL  - England
TA  - Med Mycol
JT  - Medical mycology
JID - 9815835
RN  - 0 (Antifungal Agents)
RN  - 304NUG5GF4 (Itraconazole)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antifungal Agents/*therapeutic use
MH  - Brazil
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Itraconazole/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Paracoccidioidomycosis/*drug therapy
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/*therapeutic use
MH  - Young Adult
OTO - NOTNLM
OT  - itraconazole
OT  - paracoccidioidomycosis
OT  - treatment
OT  - trimethoprim-sulfamethoxazole (TMP-SMX)
EDAT- 2014/03/01 06:00
MHDA- 2014/11/19 06:00
CRDT- 2014/03/01 06:00
PHST- 2014/03/01 06:00 [entrez]
PHST- 2014/03/01 06:00 [pubmed]
PHST- 2014/11/19 06:00 [medline]
AID - myt012 [pii]
AID - 10.1093/mmy/myt012 [doi]
PST - ppublish
SO  - Med Mycol. 2014 Apr;52(3):303-10. doi: 10.1093/mmy/myt012. Epub 2014 Jan 27.