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Avaliou-se a eficácia do fluconazol no tratamento de infecções fúngicas em 108 pacientes imunocomprometidos. As doses iniciais variaram de 50 a mais de 400 mg/dia. Dos 108 pacientes, 57 (52,8%) tinham criptococose, 45 (41,7%) candidíase e 6 (5,5%) outras infecções fúngicas, sendo que 66,6% dos pacientes eram portadores de AIDS. Dos 57 pacientes com criptococose houve acometimento do SNC em 52 (91,2%); 39 de 43 pacientes com criptococose (90,7%) e 36 de 39 dos portadores de candidíase (92,3%) curaram ou tiveram boa evolução clínica. A erradicação do fungo ocorreu em 19 de 30 casos com criptococose (63,3%) e em 21 de 26 casos com candidíase (80,7%) que puderam ser avaliados. Onze dos 108 pacientes (10,2%) apresentaram reações adversas,principalmente gastrintestinais de pequena intensidade, porém um paciente apresentou envolvimento hepático na vigência de terapêutica com fluconazol. Conclui-se que o fluconazol é droga eficaz e de baixa toxicidade para tratar criptococose e candidíase, constituindo-se boa alternativa à terapêutica convencional com anfotericina B. Fluconazole therapy was evaluated prospec-tively in 108 patients with immunossupression and serious fungal infections. Patients were enrolled if they had a life-threatening fungal infection and conventional therapy had failed to eradicate infection, had caused serious toxic reactions, or was contraindicated. Patients were treated with 50 to over 400 mg/day initially. AIDS was underlying risk factor in 66.6% of the patients evaluated in the study and in 92.9% of 57 patients with cryptococcal infection. Satisfactory clinical response was observed in 43 patients with active cryptococcal infection and in 39 patients with active candidiasis, 90.7% and 92.3% respectively. Concerning mycologic response, 63.3% and 80.7% of 30 patients with cryptococcal infection and 26 patients with candidiasis respectively had final negative cultures. Eleven patients (10.2%) had adverses effects possibly due to fluconazole therapy. Fluconazole may be effective in the treatment of cryptococcal infection and candidiasis and can be an alternative to conventional antifungal therapy

Tratamento pelo fluconazol de pacientes imuno-comprometidos com graves infecções fúngicas