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May 19, 1989

Infectious Diseases

JAMA. 1989;261(19):2851-2853. doi:10.1001/jama.1989.03420190127039

Infectious diseases continue to be the focus of exciting new developments in detection of new infections, treatment and prevention of known diseases, and better understanding of their pathogenesis.

In the past decade many new cephalosporins and penicillins have been introduced, as well as the new fluorinated quinolones. Some drugs offered significant pharmacokinetic advantages in addition to an expanded spectrum of activity, and the new quinolones offered, for the first time, oral therapy for serious gram-negative rod infections. One of the most exciting new agents is fluconazole, a new oral triazole antifungal agent that hopefully will be licensed soon. It is related to the imidazole, ketaconazole, but possesses significant advantages. It is well absorbed from the gastrointestinal tract and penetrates the blood-brain barrier so that cerebrospinal fluid levels are 70% to 80% of simultaneous blood levels. As a result of a serum half-life of 30 hours, once-a-day dosing is possible. It