Sporotrichosis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]

Treatment

Form	Primary Line of Treatment	Alternative Treatment	Remarks/Other
Uncomplicated cutaneous	Itraconazole 200 mg PO qd	Itraconazole 200 mg PO bid, OR Terbinafine 500 mg PO bid, OR SSKI increasing doses, OR Fluconazole 400-800 mg PO qd, OR Local hyperthermia	Continue treatment for 2-4 weeks after lesions resolve.
Osteoarticular	Itraconazole 200 mg PO bid	Limposomal amphotericin B 3-5 mg/kg IV qd OR Deoxycholate amphotericin B 0.7-1 mg/kg IV qd until symptom resolution	For a total of 12 months, switch to Itraconazole after resolution/end of treatment.
Pulmonary	Limposomal amphotericin B 3-5 mg/kg IV qd THEN Itraconazole 200 mg PO bid	Deoxycholate amphotericin B 0.7-1 mg/kg IV qd THEN Itraconazole 200 mg PO bid upon symptom resolution	Treat less sever cases with a 12 month regimen of Itraconazole.
Meningeal	Limposomal amphotericin B 3-5 mg/kg IV qd THEN Itraconazole 200 mg PO bid	Deoxycholate amphotericin B 0.7-1 mg/kg IV qd THEN Itraconazole 200 mg PO bid upon symptom resolution	Precise length of amphotericin B treatment varies. Suppressive treatment with Itraconazole is necessary.
Dissimated	Limposomal amphotericin B 3-5 mg/kg IV qd THEN Itraconazole 200 mg PO bid.	Deoxycholate amphotericin B 0.7-1 mg/kg IV qd THEN Itraconazole 200 mg PO bid upon symptom resolution	Continue amphotericin B treatment until patient shows marked improvement for a minimum of 12 months. Suppressive treatment with Itraconazole is necessary.
Sporotrichosis in pregnant women	Treat with limposomal amphotericin B 3-5 mg/kg IV qd OR Deoxycholate amphotericin B 0.7-1 mg/kg IV qd only for severe cases of sporotrichosis OR In cases of uncomplicated cutaneous, treat with only hyperthermia.		It is preferable to defer treatment in uncomplicated cases.
Sporotrichosis in Children	Itraconazole 6-10 mg PO qd to a max of 400 mg PO qd for mild cases OR Deoxycholate amphotericin B 0.7-1 mg/kg IV qd for severe cases	SSKI increasing doses equivalent to half the adult dose, continuing treatment for 2-4 weeks after resolution of symptoms.