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Increased gastric pH and the bioavailability of fluconazole and ketoconazole

Article Abstract:

Antacids and other anti-ulcer drugs, such as cimetidine, cause the acid level of the stomach to drop, which increases the pH reading of stomach fluids. (pH is an index of relative acidity.) Some drugs are better absorbed and therefore more readily available to the body when digested by the normally acidic stomach, and can be much less effective when given with cimetidine or other anti-ulcer drugs. Two drugs that can be taken by mouth are currently available to treat fungal infections, ketoconazole and the newer fluconazole. A group of 24 healthy male volunteers were given standard doses of fluconazole, with and without cimetidine, and ketoconazole, with and without cimetidine, and then had levels of the antifungal drugs in the bloodstream measured. The blood level of ketoconazole was greatly reduced when given with cimetidine, while the blood level of the fluconazole was unchanged. Patients with the acquired immunodeficiency syndrome (AIDS) and the elderly are the most likely patients to develop fungal infections, and both groups have a tendency to have abnormally low levels of stomach acid (and the elderly are not infrequently taking cimetidine or drugs like it), making these two groups better candidates for fluconazole than ketoconazole when antifungal agents are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Evaluation, Physiological aspects, AIDS patients, Drug use, Fluconazole, Gastric acid, Ketoconazole

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Coccidioidomycosis: A Regional Disease of National Importance

Article Abstract:

Accurate diagnosis of coccidiomycosis may prevent the inappropriate use of antibacterial drugs and reduce the complications of this fungal infection. Infection by the Coccidiodes fungus often resolves without treatment, but it can cause pneumonia or other chronic infection in immunosuppressed patients. The disease is endemic in the southwestern US, where the fungus grows in soil. Additional research may reveal effective methods to control the growth and transmission of the fungus in the environment.

United States, Health aspects, Analysis, Coccidioides immitis, Ascomycota

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Comparison of the drugs fluconazole or itraconazole to treat coccidioidomycosis infection

Article Abstract:

Fluconazole and itraconazole appear to be equally effective in treating a fungal infection called coccidioidomycosis. This was the conclusion of a study of 191 patients who were randomly assigned to take one drug or the other.

Drug therapy

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