Correlation of posaconazole minimum fungicidal concentration and time kill test against nine Candida species

Sóczó, G.; Kardos, Gábor; McNicholas, Paul M.; Balogh, Enikő; Gergely, Lajos; Varga, I.; Kelentey, B; Majoros, László

doi:10.1093/jac/dkm350

Cited by 31 publications

(10 citation statements)

References 22 publications

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“…Itraconazole is moderately active against most medically important fluconazole-susceptible and -resistant Candida species, with the exception of C. glabrata (Pfaller et al, 2005). Posaconazole exerts fungistatic activity against some NCAC species, including C. glabrata, C. tropicalis and C. parapsilosis (Scozo et al, 2007). This agent is generally active against Candida species including fluconazole-resistant C. albicans and C. glabrata (Pfaller & Diekema, 2007).…”

Section: Antifungal Therapies and Mechanisms Of Resistance Of Ncac Spmentioning

confidence: 99%

“…With the exception of C. tropicalis, voriconazole is more active than fluconazole against medically important Candida species (Pfaller & Diekema, 2007). Posaconazole exerts fungistatic activity against some NCAC species, including C. glabrata, C. tropicalis and C. parapsilosis (Scozo et al, 2007). Flucytosine has a narrow spectrum of activity, and several mechanisms of resistance are possible due to the multiple intracellular enzymatic steps required for its action.…”

Section: Antifungal Therapies and Mechanisms Of Resistance Of Ncac Spmentioning

confidence: 99%

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Candida glabrata, Candida parapsilosisandCandida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance

et al. 2012

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The incidence of infections caused by Candida species (candidosis) has increased considerably over the past three decades, mainly due to the rise of the AIDS epidemic, an increasingly aged population, higher numbers of immunocompromised patients and the more widespread use of indwelling medical devices. Candida albicans is the main cause of candidosis; however, non-C. albicans Candida (NCAC) species such as Candida glabrata, Candida tropicalis and Candida parapsilosis are now frequently identified as human pathogens. The apparent increased emergence of these species as human pathogens can be attributed to improved identification methods and also associated with the degree of diseases of the patients, the interventions that they were subjected and the drugs used. Candida pathogenicity is facilitated by a number of virulence factors, most importantly adherence to host surfaces including medical devices, biofilm formation and secretion of hydrolytic enzymes (e.g. proteases, phospholipases and haemolysins). Furthermore, despite extensive research to identify pathogenic factors in fungi, particularly in C. albicans, relatively little is known about NCAC species. This review provides information on the current state of knowledge on the biology, identification, epidemiology, pathogenicity and antifungal resistance of C. glabrata, C. parapsilosis and C. tropicalis.

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Section: Antifungal Therapies and Mechanisms Of Resistance Of Ncac Spmentioning

confidence: 99%

Section: Antifungal Therapies and Mechanisms Of Resistance Of Ncac Spmentioning

confidence: 99%

Candida glabrata, Candida parapsilosisandCandida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance

et al. 2012

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“…After filtration, fluconazole is highly reabsorbed by the kidney [62]. Dosing should be reduced in subjects with renal impairment; however, continuous renal replacement therapy might result in lower concentrations than expected because of the lack of renal reabsorption in this setting [63]. …”

Section: Triazolesmentioning

confidence: 99%

“…In addition to Aspergillus sp., posaconazole is also active against other molds, including zygomycetes, as opposed to voriconazole. Similar to other triazoles, posaconazole is fungicidal in vitro with time-dependent killing against most Candida species and molds [63, 75]. In animal models, the duration of exposure to plasma concentrations above the MIC is the most important parameter for optimum efficacy [109].…”

Section: Triazolesmentioning

confidence: 99%

Pharmacokinetics and Pharmacodynamics of Antifungals in Children: Clinical Implications

Autmizguine

Guptill

Cohen‐Wolkowiez

et al. 2014

Drugs

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Invasive fungal disease (IFD) remains life-threatening in premature infants and immunocompromised children despite the recent development of new antifungal agents. Optimal dosing of antifungals is one of the few factors clinicians can control to improve outcomes of IFD. However, dosing in children cannot be extrapolated from adult data because IFD pathophysiology, immune response, and drug disposition differ from adults. We critically examined the literature on pharmacokinetics (PK) and pharmacodynamics (PD) of antifungal agents and highlight recent developments in treating pediatric IFD. To match adult exposure in pediatric patients, dosing adjustment is necessary for almost all antifungals. In young infants, the maturation of renal and metabolic functions occurs rapidly and can significantly influence drug exposure. Fluconazole clearance doubles from birth to 28 days of life and, beyond the neonatal period, agents like fluconazole, voriconazole, and micafungin require higher dosing than in adults due to faster clearance in children. As a result, dosing recommendations are specific to bracketed ranges of age. Pharmacodynamics principles of antifungals mostly rely on in vitro and in vivo models but very few pharmacodynamics studies specifically address IFD in children. Exposure-response relationship may differ in younger children compared with adults, especially in infants with invasive candidiasis who are at higher risk of disseminated disease and meningoencephalitis, and by extension severe neurodevelopmental impairment. Micafungin is the only antifungal agent for which a specific target of exposure was proposed based on a neonatal hematogenous Candida meningoencephalitis animal model. In this review, we found that pediatric data on drug disposition of newer triazoles and echinocandins are lacking, dosing of older antifungals such as fluconazole and amphotericin B products still need optimization in young infants, and that target PK/PD indices need to be clinically validated for almost all antifungals in children. A better understanding of age-specific PK and PD of new antifungals in infants and children will help improve clinical outcomes of IFD by informing dosing and identifying future research areas.

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“…It was developed from itraconazole and is available only as an oral suspension, although a new tablet formulation is currently under development [27]. It is fungicidal against Aspergillus, Cryptococcus, and Candida [28]. It is fungicidal against Aspergillus, Cryptococcus, and Candida [28].…”

Section: Posaconazolementioning

confidence: 99%

Pharmacogenomics of Antifungal Agents

Ashbee

Gilleece

2014

Handbook of Pharmacogenomics and Stratified Medicine

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Correlation of posaconazole minimum fungicidal concentration and time kill test against nine Candida species

Abstract: MFC values were good predictors of the fungistatic or fungicidal activity of posaconazole, as determined by time-kill curves, for all tested species except C. parapsilosis. Our results highlight the fungicidal action of posaconazole against a number of clinically relevant Candida species.

Cited by 31 publications

References 22 publications

Candida glabrata, Candida parapsilosisandCandida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance

Candida glabrata, Candida parapsilosisandCandida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance

Pharmacokinetics and Pharmacodynamics of Antifungals in Children: Clinical Implications

Pharmacogenomics of Antifungal Agents

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