Sporotrichosis medical therapy
Sporotrichosis Microchapters |
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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/day] | Itraconazole [200 b.i.d.], terbinafine [500 b.i.d.], SSKI [increasing doses], fluconazole [400-800 mg/day], or local hyperthermia | Continue treatment for 2-4 weeks after lesions resolve. |
Osteoarticular | Itraconazole [200 mg b.i.d.] | Limposomal amphotericin B [3-5 mg/kg/day] or deoxycholate amphotericin B [0.7-1 mg/kg/day] 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/day], followed by itraconazole [200 mg b.i.d.] | Deoxycholate amphotericin B [0.7-1 mg/kg/day], followed by itraconazole [200 mg b.i.d.] upon symptom resolution | Treat less sever cases with a 12 month regimen of itraconazole. |
Meningeal | Limposomal amphotericin B [3-5 mg/kg/day], followed by itraconazole [200 mg b.i.d.] | Deoxycholate amphotericin B [0.7-1 mg/kg/day], followed by itraconazole [200 mg b.i.d.] upon symptom resolution | Precise length of amphotericin B treatment varies. Suppressive treatment with itraconazole is necessary. |
Dissimated | Limposomal amphotericin B [3-5 mg/kg/day], followed by itraconazole [200 mg b.i.d.] | Deoxycholate amphotericin B [0.7-1 mg/kg/day], followed by itraconazole [200 mg b.i.d.] 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/day] or deoxycholate amphotericin B [0.7-1 mg/kg/day] only for severe cases of sporotrichosis.
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/day to a max of 400 mg] for mild cases
Deoxycholate amphotericin B [0.7-1 mg/kg/day] for severe cases |
SSKI [increasing doses equivalent to half the adult dose], continuing treatment for 2-4 weeks after resolution of symptoms. |