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May 16, 1980

Treatment of Coccidioidomycosis With Miconazole

Author Affiliations

From the Section of Infectious and Immunologic Diseases, Department of Internal Medicine, School of Medicine, University of California, Davis. Dr Lawrence is now with the Department of Internal Medicine, Texas Tech University School of Medicine, Lubbock.

JAMA. 1980;243(19):1923-1926. doi:10.1001/jama.1980.03300450037019

Miconazole was injected intravenously in six patients with coccidioidomycosis. Two patients received 101 and 185 g, respectively, without clinical response and with persistence of positive cultures for Coccidioides immitis. In one patient, symptoms were suppressed when amphotericin B was given with miconazole, but new lesions developed with miconazole alone (total dose, 963 g). Three patients received smaller doses: 30.6 g before death from an unrelated complication; 17 and 22.3 g before development of severe allergic reactions. Because of the high rate of initial failures and relapses, miconazole is not recommended as primary therapy for coccidioidomycosis.

(JAMA 243:1923-1926, 1980)