Documente Academic
Documente Profesional
Documente Cultură
Abstract This study evaluated the efficacy of itraconazole as a combined continuous/pulse therapy for feline
dermatophytosis. Nine cats with dermatophytosis caused by Microsporum canis were treated with itraconazole
at 10 mg kg1 orally once daily for 28 days and then on an alternate week regimen (1 week off, 1 week on) at the
same dosage. Cats were re-evaluated by physical examination and fungal culture at days 28, 42, 56 and 70 if necessary.
Treatment was stopped when two consecutive negative fungal cultures were obtained. Eight cats were cured after
56 days, with two negative cultures obtained at days 28 and 42. In one case, a positive culture was obtained at
day 28, but negative cultures were achieved at days 42 and 56. This protocol appears to be effective in the treatment
of feline dermatophytosis, although these preliminary results should be confirmed by a controlled study.
INTRODUCTION
Feline dermatophytosis is a fungal infection affecting
keratinized tissues, most commonly caused by Microsporum canis. In healthy cats it is a self-limiting disease,
but it is a zoonosis and 50% of people exposed to
affected cats or asymptomatic carriers become
infected.1
Systemic therapy is the treatment of choice in feline
dermatophytosis, and griseofulvin at 50 mg kg1 orally
once daily is still considered the drug of choice for its
efficacy and low cost.1,2 However, side effects may be common and potentially severe in cats, particularly in longhaired breeds and FIV-positive animals.1 If griseofulvin
is not successful or adverse effects are observed, itraconazole may represent an alternative optional treatment.3
Itraconazole (Sporanox, Janssen) is a triazole derivative of the azole group of drugs. It acts by altering
fungal cell membrane permeability through inhibition
of ergosterol synthesis.4,5 Itraconazole at 10 mg kg1
orally once daily has been used successfully and safely
to treat dermatophytosis in experimentally infected
cats.3 In human medicine, itraconazole has been demonstrated to persist in the stratum corneum for 3
4 weeks after discontinuation of therapy,6 and has been
widely used as a pulse therapy for dermatophytosis in
both adults and children.710
Correspondence: Silvia Colombo, University of Edinburgh, The
Royal (Dick) School of Veterinary Studies, Department of Veterinary
Clinical Studies, Hospital for Small Animals, Easter Bush Veterinary
Centre, Roslin, Midlothian EH25 9RG, UK. Tel.: +44 131 650 7650;
Fax: +44 131 650 7652; E-mail: silvia.colombo@ed.ac.uk
2001 Blackwell Science Ltd
348
S. Colombo et al.
Case
no.
Breed
Age
Sex
Duration
of lesions
Time to
mycological
cure (days)
1
2
3
4
5
6
7
8
9
Persian
Domestic Short Hair
Domestic Short Hair
Persian
Domestic Short Hair
Domestic Short Hair
Domestic Short Hair
Domestic Short Hair
Persian
4 months
1 year
7 years
2 years
2 months
2 years
2 months
3 months
2.5 years
M
NM
NM
F
M
SF
M
M
M
2 months
1 month
1.5 months
1 year
Unknown
4 months
Unknown
2 weeks
3 months
70
56
56
56
56
56
56
56
56
RESULTS
Eight cats achieved two consecutive negative cultures
on day 28 and day 42. These cats were considered
cured after 56 days, because treatment was continued
while waiting for the results of the fungal cultures. No
adverse effects were observed.
One cat was still culture positive on day 28, but
achieved two consecutive negative cultures on day 42
and day 56. This cat was considered cured in 70 days,
and no adverse effects were observed (Table 1).
DISCUSSION
From the results obtained with this study, itraconazole
as a combined continuous and pulse therapy seems to
be an effective treatment for feline dermatophytosis.
The time needed to obtain mycological cure is comparable with other protocols.3
Eight of nine cats in this study were considered cured
after 56 days. In fact, these cats may have been cured
earlier, as they were culture negative on samples taken
2001 Blackwell Science Ltd, Veterinary Dermatology, 12, 347 350
ACKNOWLEDGEMENTS
The authors are grateful to the Ambulatorio Veterinario Associato Dr F. Canepa Dr L. Portigliotti
(Novara, Italy), Clinica Veterinaria Citta' di Monza
(Monza, Italy) and to the Ambulatorio Veterinario Dr
E. Jommi (Milano, Italy) for referring the cases. The
authors are also very grateful to Drs P. B. Hill and
K. L. Thoday for their advice and comments on this
paper.
REFERENCES
1. Scott, D.W., Miller, W.H., Griffin, C.E. Muller and Kirks
Small Animal Dermatology, 6th edn. Philadelphia: W.B.
Saunders, 2001: 336.
2. Moriello, K.A., DeBoer, D.J. Feline dermatophytosis.
Recent advances and recommendations for therapy.
In: Kunkle G. Feline dermatology. Veterinary Clinics
of North America: Small Animal Practice 1995; 25:
901 21.
349
Rsum Cette tude a valu lefficacit de litraconazole dans le traitement des dermatophytoses flines en
utilisant une thrapeutique combine (continue/pulse). Neuf chats prsentant une dermatophytose due
Microsporum canis ont t traits avec litraconazole la posologie de 10 mg kg1 une fois par jour par voie orale
pendant 28 jours, puis avec un traitement puls (une semaine avec traitement, une semaine sans) au mme dosage.
Les chats ont subi un examen clinique et une culture fongique J28, J42, J56 et J70 si ncessaire. Le traitement
tait arrt lorsque deux cultures fongiques successives taient ngatives. Huit chats ont t guris aprs 56 jours,
avec deux cultures ngatives J28 et J42. Dans un cas, une culture positive a t observe J28, mais les cultures
nont t ngatives qu J42 et J56. Ce protocole apparat efficace pour le traitement des dermatophytoses flines,
bien que ces rsultats ne soient que prliminaires et ncessitent confirmation par une tude contrle.
2001 Blackwell Science Ltd, Veterinary Dermatology, 12, 347350
350
S. Colombo et al.
Resumen Este estudio evala la eficacia del itraconazol como terapia combinada continua/pulsada de la dermatosis felina. Se trataron nueve casos de dermatofitosis causada por Microsporum canis con itraconazol a
10 mg kg1 oralmente, una toma diaria durante 28 das y despus con un rgimen de semanas alternas (1 semana
sin terapia, 1 semana con terapia) con la misma dosis. Se reevaluaron los gatos mediante examen fsico y cultivo
fngico los das 28, 42, 56 y 70 cuando se estim necesario. Se par el tratamiento al obtenerse dos cultivos
fngicos negativos consecutivos. Se curaron ocho gatos a los 56 das, con dos cultivos negativos los das 28 y 42.
En un caso, se obtuvo un cultivo positivo el da 28, pero se consiguieron cultivos negativos los das 42 y 56. Este
protocolo parece ser efectivo en el tratamiento de la dermatofitosis felina, aunque estos resultados preliminares
deberan confirmarse mediante un estudio control.
Zusammenfassung Diese Studie bewertete die Wirksamkeit von Itrakonazol als kombinierte Dauer-/Pulstherapie
fr die Behandlung der felinen Dermatophytose. Neun Katzen mit durch Microsporum canis verursachter Dermatophytose wurden mit Itrakonazol in einer Dosierung von 10 mg kg1 oral einmal tglich fr 28 Tage und dann
jede zweite Woche mit derselben Dosierung behandelt. Wiederholungsuntersuchungen und Pilzkulturen wurden,
wenn ntig, nach 28, 42, 56 und 70 Tagen durchgefhrt. Die Behandlung wurde beendet, wenn zwei aufeinanderfolgende Pilzkulturen negativ waren. Acht Katzen waren nach 56 Tagen geheilt, die Pilzkulturen waren nach 28
und 42 Tagen negativ. Bei einer Katze war die Kultur am Tag 28 noch positiv, aber Kulturen waren nach 42 und
56 Tagen negativ. Dieses Behandlungsprotokol scheint fr die Behandlung der felinen Dermatophytose wirksam
zu sein, obwohl diese Resultate durch eine kontrollierte Studie besttigt werden sollten.