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Chapman SW, Dismukes WE, Proia LA, et al. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America

University of Mississippi Medical Center, Jackson, USA.
Clinical Infectious Diseases (Impact Factor: 9.42). 07/2008; 46(12):1801-12. DOI: 10.1086/588300
Source: PubMed

ABSTRACT Evidence-based guidelines for the management of patients with blastomycosis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous management guidelines published in the April 2000 issue of Clinical Infectious Diseases. The guidelines are intended for use by health care providers who care for patients who have blastomycosis. Since 2000, several new antifungal agents have become available, and blastomycosis has been noted more frequently among immunosuppressed patients. New information, based on publications between 2000 and 2006, is incorporated in this guideline document, and recommendations for treating children with blastomycosis have been noted.

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Available from: Laurie Proia, Aug 17, 2015
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    • "Amphotericin B is no longer recommended as sole therapy due to toxicity with itraconazole having fewer side effects and an efficacy over 90% in non–life-threatening blastomycosis (Bradsher, 1996; Chapman et al., 1997; Chapman et al., 2008; Dismukes et al., 1992). Voriconazole and posaconazole have in vitro activity against B. dermatitidis but are not well studied in the treatment of blastomycosis (Chapman et al., 2008; Li et al., 2000; Sugar and Liu, 1996). Voriconazole has been used to treat blastomycosis in the setting of itraconazole intolerance or sub-therapeutic drug levels and has been successful in the treatment of central nervous system blastomycosis (Borgia et al., 2006; Freifeld et al., 2009; Freifeld et al., 2010). "
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    • "e but it is important to realise that this disease is difficult to cure and relapses are highly likely . Treatment in future cases should probably therefore be continued for about 6 – 12 months or at least 3 months beyond the resolution of signs and early recurrence should be managed in timely fashion ( Bromel and Sykes 2005 ; Gilor et al . 2006 ; Chapman et al . 2008 ; Saccente and Woods 2010 ; Mazepa et al . 2011 ) ."
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    • "According to the latest guidelines [11] [12]. Patients with severe disseminated disease should be treated with AmB deoxycholate or a lipid formulation of AmB (total dose greater than 30 mg/kg) and mild to moderate disseminated blastomycosis that does not involve the CNS should be treated with itraconazole (200 or 400 mg orally daily). "
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