Focus on itraconazole: A broad-spectrum antifungal agent for treatment of blastomycosis and histoplasmosis

Itraconazole is a new azole antifungal agent active against many common fungal pathogens. The agent was recently approved by the FDA for the treatment of blastomycosis and histoplasmosis, although no controlled, comparative trials have been published. Itraconazole possesses a favorable pharmacokinetic and safety profile and can be administered once or twice daily. Absorption of itraconazole from the gastrointestinal tract is greatly enhanced by the presence of food; therefore, the drug should be administered following meals. Unlike ketoconazole, itraconazole has minimal effects upon the metabolism of endogenous steroids and other drugs. Compared with other available agents useful for the treatment of blastomycosis and histoplasmosis, itraconazole appears to be well tolerated, equally efficacious, and less toxic.