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Antifungals

Antifungals can be administered orally, subcutaneously or by inhalation in swifts. Itraconazole ("Sempera liquid", "Itrafungol") has proven to be the fastest, most tolerable and most effective protection against Aspergillus spp. infections. For manifest infections, 14-day oral administration is usually sufficient. Accompanying antibiotic therapy, it is given for 10 days.
Ketoconazole ("Nizoral") is also effective and well tolerated, but an adequate therapeutic level is only reached after a few days. Since an aspergilloma obstructing the trachea can grow within 1-2 days and lead to death by suffocation, a faster-acting antifungal is needed.
The effectiveness of Fluconazole ("Diflucan") in swifts should be evaluated cautiously. In an adult bird with a rapidly growing tracheal aspergilloma, it showed no effect. However, it is very well tolerated when injected subcutaneously. It was preferably used for prophylactic coverage of weakened, severely malnourished swifts without manifest fungal infection and given every 2 days over a period of 8-10 days.
For inhalation, Enilconazole ("Imaverol") and Amphotericin B can be used, with the latter showing significantly better effectiveness with equally good tolerability.

For infections with Candida albicans, oral treatment with Nystatin ("Nystaderm-S") has proven effective in almost all cases so far, although swifts do not particularly like the sweet medication. It is dripped directly onto the mucous membrane of the lower beak 3-4 times daily, as the preparation must come into contact with the yeast fungi.

Intolerances with the combination of different antibiotics and antifungals have not yet been observed in swifts.

ANTIFUNGALS
Active Ingredient Dosage Trade Name Manufacturer
Enilconazole 1:50 in NaCl for
inhal., BID 5-10
min., 10-14d
Imaverol Janssen-Cilag
Fluconazole 10 mg/kg p.o., SID
10-14d, 20 mg/kg
s.c. every 2nd day,
10-14d
Diflucan syrup p.o.
"Diflucan-i.v." s.c.
Pfizer
Ketoconazole 30 mg/kg p.o. SID
2 weeks
Nizoral Suspension Janssen-Cilag
Itraconazole 10 mg/kg p.o. SID
2 weeks
Sempera liquid, "Itrafungol" Janssen-Cilag
Nystatin 150,000 I.U./kg p.o.
TID-QID 10-14d
Nystaderm-S Dermapharm