One hundred sixty-five (165) renal transplants were performed in 160 patients during a 5-year period. Patients who were considered to be at high risk for the development of posttransplant coccidioidomycosis were placed on fluconazole at 100 mg daily. Although the treatment groups consisted entirely of high-risk individuals, none of the 64 patients developed clinical coccidioidomycosis. Four patients in the untreated group of 101 developed clinical coccidioidomycosis. There were no instances of toxicity related to fluconazole therapy. Evaluation of cyclosporine doses in both groups revealed a dosage reduction of 6-19 percent at various times following, transplantation. This dosage reduction partially offset the cost of fluconazole. Fluconazole prophylaxis appears to be clinically effective and cost effective when administered to high-risk renal transplant recipients.
Full conference title:
Coccidioidomycosis - Centennial Conference