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Brilhante RSN, Bittencourt PV, Lima RAC, Castelo-Branco D, Oliveira JS, Pinheiro A, Cordeiro R, Camargo ZP, Sidrim JJC, Rocha MFG. Coccidioidomycosis and Histoplasmosis in Equines: An Overview to Support the Accurate Diagnosis. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
- H. B. Chidlow
- Hagyard Equine Medical Institute; Lexington Kentucky USA
| | - N. M. Slovis
- Hagyard Equine Medical Institute; Lexington Kentucky USA
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Abstract
STUDY DESIGN Review of the literature. OBJECTIVE To retrospectively examine the frequency of published fungal infections by species and the treatment algorithms used to eradicate the disease. SUMMARY OF BACKGROUND DATA Fungal infections of the spine present unique challenges to the modern multispecialty treatment team. Although rare in comparison with bacterial infections, fungal infections have been increasing in incidence over the past several decades. Evidences-based practice is limited to referencing smaller case series. METHODS MEDLINE, Scopus, and EMBASE searches were carried out by one of the authors as well as by the research desk at the University of Miami/Calder Memorial Library. We included peer-reviewed articles published between 1948 and September 2010; case reports, series, and reviews were all examined and compiled into a database. RESULTS A total of 130 articles, representing 157 cases, were included in the review. Aspergillus (60 cases, 38.2% of the total) and Candida species (36 cases, 22.9% of the total) were the 2 most common organisms. Surgery was associated with a greater survival rate than medical management alone in patients with Aspergillus (26.9% mortality in surgical patients; 60% in medically treated patients) and Candida (0% vs. 28.6%). Overall mortality was 19.3%. The overall recurrence rate was 7.4%. Amphotericin use was associated with a higher mortality rate than azoles. CONCLUSION Aspergillus is the most common published pathogen in fungal infections of the spine. Recent publications depicting the use of newer antifungal medications such as azoles report higher survival rates. Surgically treated patients in combination with antifungal therapy showed highest frequencies of patient survival in Aspergillus and Candida infections. LEVEL OF EVIDENCE 3.
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Freeman CE, Mirza MH, Pescosolido KC, McConnico RS. Injuries and outcome of three horses hospitalised in the aftermath of Hurricane Isaac. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- C. E. Freeman
- Department of Veterinary Clinical Sciences; Louisiana State University Veterinary Teaching Hospital; Baton Rouge USA
| | - M. H. Mirza
- Department of Veterinary Clinical Sciences; Louisiana State University Veterinary Teaching Hospital; Baton Rouge USA
| | - K. C. Pescosolido
- Department of Veterinary Clinical Sciences; Louisiana State University Veterinary Teaching Hospital; Baton Rouge USA
| | - R. S. McConnico
- Department of Veterinary Clinical Sciences; Louisiana State University Veterinary Teaching Hospital; Baton Rouge USA
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Affiliation(s)
- S. D. White
- Department of Medicine and Epidemiology; School of Veterinary Medicine; University of California; Davis USA
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Abstract
Fungal respiratory disease is a rare occurrence in horses. Fungal organisms are ubiquitous in the equine environment; however, there is a geographic predisposition for disease development, with fungal respiratory infections seen more commonly by practitioners working in tropical or subtropical environments. Diagnosis and treatment of fungal respiratory infections pose a challenge for the equine practitioner, and the prognosis for complete resolution of infection is often guarded; however, new antifungal medications are likely to improve treatment success. This article summarizes the available literature regarding the cause, diagnosis, and treatment of equine fungal respiratory disease.
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Affiliation(s)
- Allison J Stewart
- J.T. Vaughan Large Animal Teaching Hospital, Department of Clinical Sciences, Auburn University College of Veterinary Medicine, 1500 Wire Road, Auburn, AL 36849, USA.
| | - Rosemary S Cuming
- J.T. Vaughan Large Animal Teaching Hospital, Department of Clinical Sciences, Auburn University College of Veterinary Medicine, 1500 Wire Road, Auburn, AL 36849, USA
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Weese JS, Yu AA. Infectious Folliculitis and Dermatophytosis. Vet Clin North Am Equine Pract 2013; 29:559-75. [DOI: 10.1016/j.cveq.2013.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Cafarchia C, Figueredo LA, Otranto D. Fungal diseases of horses. Vet Microbiol 2013; 167:215-34. [PMID: 23428378 DOI: 10.1016/j.vetmic.2013.01.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 01/13/2013] [Accepted: 01/17/2013] [Indexed: 10/27/2022]
Abstract
Among diseases of horses caused by fungi (=mycoses), dermatophytosis, cryptococcosis and aspergillosis are of particular concern, due their worldwide diffusion and, for some of them, zoonotic potential. Conversely, other mycoses such as subcutaneous (i.e., pythiosis and mycetoma) or deep mycoses (i.e., blastomycosis and coccidioidomycosis) are rare, and/or limited to restricted geographical areas. Generally, subcutaneous and deep mycoses are chronic and progressive diseases; clinical signs include extensive, painful lesions (not pathognomonic), which resemble to other microbial infections. In all cases, early diagnosis is crucial in order to achieve a favorable prognosis. Knowledge of the epidemiology, clinical signs, and diagnosis of fungal diseases is essential for the establishment of effective therapeutic strategies. This article reviews the clinical manifestations, diagnosis and therapeutic protocols of equine fungal infections as a support to early diagnosis and application of targeted therapeutic and control strategies.
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Affiliation(s)
- Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari, Str. prov.le per Casamassima Km 3, 70010 Valenzano, Bari, Italy.
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Passler NH, Chan HM, Stewart AJ, Duran SH, Welles EG, Lin HC, Ravis WR. Distribution of voriconazole in seven body fluids of adult horses after repeated oral dosing. J Vet Pharmacol Ther 2010; 33:35-41. [PMID: 20444023 DOI: 10.1111/j.1365-2885.2009.01099.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to assess safety and alterations in body fluid concentrations of voriconazole in normal horses on days 7 and 14 following once daily dose of 4 mg/kg of voriconazole orally for 14 days. Body fluid drug concentrations were determined by the use of high performance liquid chromatography (HPLC). On day 7, mean voriconazole concentrations of plasma, peritoneal, synovial and cerebrospinal fluids, aqueous humor, epithelial lining fluid (ELF), and urine were 1.47 +/- 0.63, 0.61 +/- 0.22, 0.70 +/- 0.20, 0.62 +/- 0.26, 0.55 +/- 0.32, 79.45 +/- 69.4, and 1.83 +/- 0.44 microg/mL respectively. Mean voriconazole concentrations in the plasma, peritoneal, synovial and cerebrospinal fluids, aqueous humor, ELF and urine on day 14 were 1.60 +/- 0.37, 1.02 +/- 0.27, 0.86 +/- 0.25, 0.64 +/- 0.21, 0.68 +/- 0.13, 47.76 +/- 45.4 and 3.34 +/- 2.17 respectively. Voriconazole concentrations in the bronchoalveolar cell pellet were below the limit of detection. There was no statistically significant difference between voriconazole concentrations of body fluids when comparing days 7 and 14. Results indicated that voriconazole distributes widely into body fluids.
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Affiliation(s)
- N H Passler
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, AL 36849-2900, USA.
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Colitz CMH, Latimer FG, Cheng H, Chan KK, Reed SM, Pennick GJ. Pharmacokinetics of voriconazole following intravenous and oral administration and body fluid concentrations of voriconazole following repeated oral administration in horses. Am J Vet Res 2008; 68:1115-21. [PMID: 17916020 DOI: 10.2460/ajvr.68.10.1115] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of voriconazole following IV and PO administration and assess the distribution of voriconazole into body fluids following repeated PO administration in horses. ANIMALS 6 clinically normal adult horses. PROCEDURES All horses received voriconazole (10 mg/kg) IV and PO (2-week interval between treatments). Plasma voriconazole concentrations were determined prior to and at intervals following administration. Subsequently, voriconazole was administered PO (3 mg/kg) twice daily for 10 days to all horses; plasma, synovial fluid, CSF, urine, and preocular tear film concentrations of voriconazole were then assessed. RESULTS Mean +/- SD volume of distribution at steady state was 1,604.9 +/- 406.4 mL/kg. Systemic bioavailability of voriconazole following PO administration was 95 +/- 19%; the highest plasma concentration of 6.1 +/- 1.4 microg/mL was attained at 0.6 to 2.3 hours. Mean peak plasma concentration was 2.57 microg/mL, and mean trough plasma concentration was 1.32 microg/mL. Mean plasma, CSF, synovial fluid, urine, and preocular tear film concentrations of voriconazole after long-term PO administration were 5.163 +/- 1.594 microg/mL, 2.508 +/- 1.616 microg/mL, 3.073 +/- 2.093 microg/mL, 4.422 +/- 0.8095 microg/mL, and 3.376 +/- 1.297 microg/mL, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that voriconazole distributed quickly and widely in the body; following a single IV dose, initial plasma concentrations were high with a steady and early decrease in plasma concentration. Absorption of voriconazole after PO administration was excellent, compared with absorption after IV administration. Voriconazole appears to be another option for the treatment of fungal infections in horses.
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Affiliation(s)
- Carmen M H Colitz
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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Abstract
Coccidioides spp. appear capable of infecting all mammals and at least some reptiles. Development of disease as a result of infection is species-dependent. Dogs seem to have a susceptibility similar to that of humans, with subclinical infections, mild-to-severe primary pulmonary disease, and disseminated disease. Whereas central nervous system disease in humans is typically meningitis, brain disease in dogs and cats takes the form of granulomatous parenchymal masses. Osteomyelitis is the most common form of disseminated disease in the dog, while skin lesions predominate in the cat. Orally administered azole antifungal agents are the backbone of therapy in animals as they are in humans.
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Affiliation(s)
- Lisa F Shubitz
- Department of Veterinary Science and Microbiology, Bldg. 90, Room 221, University of Arizona, Tucson, Arizona 85721, USA.
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Higgins JC, Pusterla N, Pappagianis D. Comparison of Coccidioides immitis serological antibody titres between forms of clinical coccidioidomycosis in horses. Vet J 2007; 173:118-23. [PMID: 16249106 DOI: 10.1016/j.tvjl.2005.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2005] [Indexed: 11/24/2022]
Abstract
A retrospective study was performed to determine if there is an association between serological Coccidioides immitis antibody titres (IgG) and form/severity of coccidioidal disease in horses, and to identify trends in survival and treatment success based on the form of the disease. Data were obtained on horses with positive serological titres tested at the Coccidioidomycosis Serology Laboratory, School of Medicine, University of California, Davis from 1981 to 2004. Thirty-nine cases in which a diagnosis of coccidioidomycosis had been made were selected for inclusion. Six distinct categories were identified including abortion (n=6), miliary/interstitial pneumonia (n=6), pneumonia with thoracic effusion (pleural or pericardial) (n=11), disseminated (n=10), osteomyelitis (n=3) and external abscessation (n=3) both without pulmonary disease. Statistical differences in titre distribution were found between the abortion category and the pulmonary category (P=0.003), the abortion category and pneumonia with thoracic effusion (P=0.001), the abortion category and disseminated disease (P=0.001), and the pulmonary form and pneumonia with effusion (P=0.001). The other categories had overlapping titre results. Higher serological antibody titres seemed to be associated with a poorer prognosis for survival. Categories with the highest titres, disseminated (geometric mean titre=104) and pneumonia with thoracic effusion (geometric mean titre=226), were overwhelmingly fatal (19/21 known deaths) due to severe clinical disease. The categories with lower titres, abortion (geometric mean titre=4), bone involvement only (geometric mean titre=13) and cutaneous (geometric mean titre=5), had a better survival rate (10/12 known survivors) and less severe clinical disease. Measurement of serological titre may be a useful diagnostic aid in establishing form and severity of disease and thus inform prognosis.
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Affiliation(s)
- Jill C Higgins
- Loomis Basin Large Animal Services, Loomis, CA 95650, USA.
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Lenard ZM, Lester NV, O'hara AJ, Hopper BJ, Lester GD. Disseminated cryptococcosis including osteomyelitis in a horse. Aust Vet J 2007; 85:51-5; quiz 85. [PMID: 17300456 DOI: 10.1111/j.1751-0813.2006.00060.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 4-year-old Arab mare was diagnosed with disseminated cryptococcosis, including osteomyelitis of the proximal phalanx of the left hind limb, osteomyelitis with associated soft tissue granuloma of a rib and disseminated, large cryptococcal nodules in the lungs. The lesion in the dorsoproximal aspect of the proximal phalanx had a large area of cortical lysis with spiculated periosteal new bone and extensive soft tissue swelling. The affected rib had a pathological fracture. Cryptococcal osteomyelitis has not been previously reported in horses but should be considered as a differential diagnosis, particularly in endemic regions.
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Affiliation(s)
- Z M Lenard
- Murdoch University Veterinary Hospital, School of Veterinary and Biomedical Sciences, Murdoch University, WA 6150, USA.
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Sherman KM, Myhre GD, Heymann EI. Fungal osteomyelitis of the axial border of the proximal sesamoid bones in a horse. J Am Vet Med Assoc 2006; 229:1607-11. [PMID: 17107317 DOI: 10.2460/javma.229.10.1607] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 12-year-old Standardbred gelding was referred for swelling of the right metacarpophalangeal joint. CLINICAL FINDINGS Ultrasonography of the right metacarpal area revealed hypoechoic areas in the right digital sheath and metacarpophalangeal joint consistent with synovial effusion. Radiography of the right metacarpophalangeal joint revealed lysis of the axial border of the proximal sesamoid bones. Aspergillus fumigatus was detected on fungal culture of synovial fluid. TREATMENT AND OUTCOME Regional limb perfusion (150 mg of amikacin in 60 mL of saline [0.9% NaCl] solution perfused for 30 minutes) was performed 2 and 4 days after admission. Itraconazole (5 mg/kg [2.27 mg/lb], PO, q 24 h) was administered for approximately 9 weeks. Joint lavage with amikacin (500 mg) in 1 L of saline solution was performed 4 times. Three months after discharge, the owner reported that the horse was mildly lame during trotting but was moving freely and comfortably during all gaits and had gained a considerable amount of weight. Because the osteoarthritis was not expected to improve and because it was recommended that the horse not return to purposeful exercise, the owner decided to retire the horse from racing. CLINICAL RELEVANCE Various diagnostic imaging methods and fungal cultures are useful for diagnosing fungal osteomyelitis of the axial borders of the proximal sesamoid bones in horses. Fungal osteomyelitis of the sesamoid bones and erosive arthritis should be considered as a differential diagnosis for horses in which corticosteroids have been administered intra-articularly.
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Affiliation(s)
- Kevin M Sherman
- Myhre Equine Clinic, 100 Ten Rod Rd, PO Box 1673, Rochester, NH 03866, USA
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Davis JL, Salmon JH, Papich MG. Pharmacokinetics and tissue distribution of itraconazole after oral and intravenous administration to horses. Am J Vet Res 2006; 66:1694-701. [PMID: 16273899 DOI: 10.2460/ajvr.2005.66.1694] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of itraconazole after IV or oral administration of a solution or capsules to horses and to examine disposition of itraconazole in the interstitial fluid (ISF), aqueous humor, and polymorphonuclear leukocytes after oral administration of the solution. ANIMALS 6 healthy horses. PROCEDURE Horses were administered itraconazole solution (5 mg/kg) by nasogastric tube, and samples of plasma, ISF, aqueous humor, and leukocytes were obtained. Horses were then administered itraconazole capsules (5 mg/kg), and plasma was obtained. Three horses were administered itraconazole (1.5 mg/kg, IV), and plasma samples were obtained. All samples were analyzed by use of high-performance liquid chromatography. Plasma protein binding was determined. Data were analyzed by compartmental and noncompartmental pharmacokinetic methods. RESULTS Itraconazole reached higher mean +/- SD plasma concentrations after administration of the solution (0.41 +/- 0.13 microg/mL) versus the capsules (0.15 +/- 0.12 microg/mL). Bioavailability after administration of capsules relative to solution was 33.83 +/- 33.08%. Similar to other species, itraconazole has a high volume of distribution (6.3 +/- 0.94 L/kg) and a long half-life (11.3 +/- 2.84 hours). Itraconazole was not detected in the ISF, aqueous humor, or leukocytes. Plasma protein binding was 98.81 +/- 0.17%. CONCLUSIONS AND CLINICAL RELEVANCE Itraconazole administered orally as a solution had higher, more consistent absorption than orally administered capsules and attained plasma concentrations that are inhibitory against fungi that infect horses. Administration of itraconazole solution (5 mg/kg, PO, q 24 h) is suggested for use in clinical trials to test the efficacy of itraconazole in horses.
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Affiliation(s)
- Jennifer L Davis
- Clinical Pharmacology Laboratory, Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
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Rochette F, Engelen M, Vanden Bossche H. Antifungal agents of use in animal health--practical applications. J Vet Pharmacol Ther 2003; 26:31-53. [PMID: 12603775 DOI: 10.1046/j.1365-2885.2003.00457.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this paper is to provide an overview of antifungal agents currently in use in veterinary medicine. The practical applications and the therapeutic regimens that have proved successful in the treatment and prevention of fungal infections in dogs and cats, cattle and sheep, horse, pig, poultry and other birds, rodents, rabbits and fur animals are summarized.
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Affiliation(s)
- F Rochette
- Janssen Animal Health B.V.B.A., Turnhoutsebaan, Beerse, Belgium
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Latimer FG, Colitz CM, Campbell NB, Papich MG. Pharmacokinetics of fluconazole following intravenous and oral administration and body fluid concentrations of fluconazole following repeated oral dosing in horses. Am J Vet Res 2001; 62:1606-11. [PMID: 11592327 DOI: 10.2460/ajvr.2001.62.1606] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of fluconazole in horses. ANIMALS 6 clinically normal adult horses. PROCEDURE Fluconazole (10 mg/kg of body weight) was administered intravenously or orally with 2 weeks between treatments. Plasma fluconazole concentrations were determined prior to and 10, 20, 30, 40, and 60 minutes and 2, 4, 6, 8, 10, 12, 24, 36, 48, 60, and 72 hours after administration. A long-term oral dosing regimen was designed in which all horses received a loading dose of fluconazole (14 mg/kg) followed by 5 mg/kg every 24 hours for 10 days. Fluconazole concentrations were determined in aqueous humor, plasma, CSF, synovial fluid, and urine after administration of the final dose. RESULTS Mean (+/- SD) apparent volume of distribution of fluconazole at steady state was 1.21+/-0.01 L/kg. Systemic availability and time to maximum plasma concentration following oral administration were 101.24+/-27.50% and 1.97+/-1.68 hours, respectively. Maximum plasma concentrations and terminal half-lives after IV and oral administration were similar. Plasma, CSF, synovial fluid, aqueous humor, and urine concentrations of fluconazole after long-term oral administration of fluconazole were 30.50+/-23.88, 14.99+/-1.86, 14.19+/-5.07, 11.39+/-2.83, and 56.99+/-32.87 microg/ml, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Bioavailability of fluconazole was high after oral administration to horses. Long-term oral administration maintained plasma and body fluid concentrations of fluconazole above the mean inhibitory concentration (8.0 mg/ml) reported for fungal pathogens in horses. Fluconazole may be an appropriate agent for treatment of fungal infections in horses.
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Affiliation(s)
- F G Latimer
- Department of Companion Animal and Special Species, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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Davis EW, Legendre AM. Successful treatment of guttural pouch mycosis with itraconazole and topical enilconazole in a horse. Vet Med (Auckl) 1994; 8:304-5. [PMID: 7983630 DOI: 10.1111/j.1939-1676.1994.tb03239.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- E W Davis
- College of Veterinary Medicine, Large Animal Teaching Hospital, Ames, IA 50011-1250
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Korenek NL, Legendre AM, Andrews FM, Blackford JT, Wan PY, Breider MA, Rinaldi MG. Treatment of mycotic rhinitis with itraconazole in three horses. J Vet Intern Med 1994; 8:224-7. [PMID: 8064660 DOI: 10.1111/j.1939-1676.1994.tb03221.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Itraconazole, a third-generation azole, was evaluated for treatment of resistant nasal mycotic infections in horses. Two horses with Aspergillus spp nasal granulomas and 1 horse with Conidiobolus coronatus nasal infection were treated with itraconazole (3 mg/kg PO bid). One of the horses with nasal aspergillosis was also treated by surgical resection of the nasal septum. The treatment time for the horses ranged from 3 to 4.5 months. No adverse effects were noted in any of the horses during the treatment period. Peak and trough serum itraconazole concentrations were < 0.5 micrograms/mL in all 3 horses. Itraconazole (3 mg/kg PO bid) appears to be effective in the treatment of nasal Aspergillus spp infections in horses because the fungal infection was eliminated in both horses. One horse still had excessive nasal sounds during exercise and was retired from training, whereas the other horse returned to normal. The nasal C. coronatus infection appeared resistant to itraconazole treatment in the affected horse because the granulomas were still present after 4.5 months of treatment.
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Affiliation(s)
- N L Korenek
- Department of Rural Practice, College of Veterinary Medicine, University of Tennessee, Knoxville
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