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Journal of Antimicrobial Chemotherapy (1987) 20, 719-724
© 1987 The British Society for Antimicrobial Chemotherapy

research-article

A comparison of the efficacy of itraconazole, amphotericin B and 5-fluorocytosine in the treatment of Aspergillus fumigatus endocarditis in the rabbit

L. P. Longman and M. V. Martin

School of Dental Surgery, University of Liverpool Pembroke Place, Liverpool L69 3BX, U.K.

accepted 24 June 1987

The efficacy of amphotericin B, 5-fluorocytosine and itraconazole was compared for the treatment of experimental rabbit Aspergillus fumigatus endocarditis. Therapy with amphotericin B or 5-fluorocytosine, at dosages of 3.0 and 35 mg/kg body weight respectively, failed to eradicate aspergillus from the cardiac vegetations in all but one of the animals tested; none of these animals survived for longer than nine treatment days. When similar doses of amphotericin and 5-fluorocytosine were administered concomittantly, 30% of the animals had sterile vegetations. Itraconazole at 2.5 and 3.5 mg/kg body weight was not successful; all the animals tested had infected vegetations and did not survive beyond nine days of therapy. In contrast, itraconazole at 5.0 mg/kg sterilised the endocardial vegetations and all these animals survived for 14 days. It is concluded that itraconazole may be useful in the treatment of aspergillus endocarditis.


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