Clinical and experimental evidence on miconazole for the treatment of systemic mycoses: a review.

Intravenous treatment with miconazole brought about the recovery of 90% of patients with gastrointestinal or systemic candidosis. Miconazole given by the same route has also been found effective in the treatment of cryptococcosis, coccidioidomycosis, and paracoccidioidomycosis. Cryptococcal and coccidioidal meningitis have been cured by combined intravenous and intrathecal instillation, although treatment of aspergillosis has presented difficulty. Oral treatment was effective in curing dermatophyte skin infections and systemic mycoses caused by sensitive organisms such as paracoccidioides, blastomyces and histoplasma. The question of blood levels following oral and intravenous administration is discussed. Side effects of the drug were few, and included chills, dizziness, skin rash, itching and diarrhoea. Thus miconazole can safely be given to seriously ill patients. Its behaviour in the body is not influenced by renal insufficiency and no drug induced resistance has been reported.