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Coccidioidomycosis is usually a self-limited infection, but chronic, life-threatening disease can develop, especially in immunocompromised individuals. Treatment options include amphotericin B and azole antifungals. In animal models, the recently licensed posaconazole (see Journal Watch Infectious Diseases Oct 4 2006) has the highest activity of the azoles.
In a recent industry-sponsored, open-label study, researchers in the U.S. and Mexico investigated the use of posaconazole (800 mg/day) in a series of 15 patients with chronic coccidioidomycosis that was refractory to conventional therapy. Eight patients suffered from severe underlying conditions, some of which were associated with immunosuppression. Coccidioidal disease had been present f…