PEREZ A; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 718 (abstract no. 1082).

Novartis Pharma, Basel, SWITZERLAND.

Fungal mycetoma (Madura foot) is characterised by: tumefaction, sinuses, and discharge of grains. The disease occurs preferentially in rural areas of Mexico, Asia, and Africa. At present, there is little effective medical treatment except for surgery and in severe cases amputation.Terbinafine (Lamisil[TM]) is a fungicidal agent of the allylamin class and shows activity against Madurella spp. MIC: 1.0 - 4.0 microg/mL. An open study, involving 30 patients with fungal mycetoma recruited in one centre in Senegal is underway. Oral terbinafine 1000 mg/day is given over a period of 24 to 48 weeks. At this time, data are available for 10 pts., still ongoing in the trial, and treated for more than 16 weeks.These 10 pts. (7 m, 3 f) aging from 20-39 yrs have a duration of disease prior to therapy between 3 and 48 months. Nine pts. were denovo and 1 was a recurrence. A mycological confirmation of Madurella mycetomatis infection was achieved in all pts. At baseline all had tumefaction and emission of grains and 9 out of 10 had open sinus. After the first 4 wks of treatment an improvement in clinical signs and symptoms was seen in 8 out of 10 pts. and no change in 2 pts. One patient has been treated for 16 weeks: sinus remain open, tumefaction unchanged and emission of grains absent and the overall status has improved. Seven pts. have been treated for 24 weeks: 2 have closed sinus, tumefaction improved in 5 and no change in one and exacerbated in one; emission of grains absent in 5 and present in 2. In 6 pts. overall status has improved and in one the status deteriorated. Two pts. have been treated for 32 weeks: both have open sinus, tumefaction improved in one patient and absent in the other and emission of grains present in one patient and absent in the other. Both pts. Overall status has improved. Thus far, there have been no serious adverse events. Terbinafine appears to be a safe and effective agent for the treatment of fungal mycetoma.

Publication Types:

• Meeting Abstracts

Keywords:

• Africa
• Asia
• Humans
• Madurella
• Maduromycosis
• Mexico
• Microbial Sensitivity Tests
• Naphthalenes
• Physical Therapy Modalities
• Senegal
• terbinafine

Other ID:

• GWAIDS0008958

UI: 102246455

From Meeting Abstracts