New antifungal agents for the treatment of candidaemia

Muñóz, Patricia; Guinea, Jesús; Rojas, Loreto; Bouza, Emilio

doi:10.1016/j.ijantimicag.2010.11.007

Cited by 12 publications

(6 citation statements)

References 73 publications

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“…However, the indiscriminate application of risk factor-based prediction models leads to a massive increase in the number of unnecessarily treated patients [3]. New antifungals have slight differences in the spectrum of action, dose required, route of administration, and interactions with other drugs, which are difficult to manage by a non-fungal specialist [3]. Therefore, the need for stewardship programmes targeting antifungals has been raised [3,4].…”

Section: Introductionmentioning

confidence: 99%

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A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital

López‐Medrano¹,

Juan²,

Lizasoaín³

et al. 2013

Clinical Microbiology and Infection

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Antimicrobial stewardship programmes promote excellence in the use of antimicrobials by selecting the appropriate antimicrobial agent and the correct dose, route of administration and duration of treatment. However, there is limited experience with such programmes targeting antifungal treatments. We present the results of a non-compulsory programme for the control of antifungals. For 12 months, prescriptions of oral voriconazole or intravenous voriconazole, caspofungin and liposomal amphotericin B were reviewed, and non-compulsory recommendations were made. The incidence and outcome of fungal infections were examined. The results for the dispensed defined daily doses (DDDs) and expenditure on antifungals were compared with those for the previous 12 months. The number of antifungal treatments reviewed was 662. A recommendation to change treatment was made in 29% of the cases, including a change from intravenous to oral treatment (15%), cessation of antifungal treatment (8%), and a change to fluconazole (6%). The DDDs of intravenous voriconazole and caspofungin were reduced by 31.4% and 20.2%, respectively. The DDDs of oral voriconazole and dispensed vials of liposomal amphotericin B were increased by 8.2% and 13.9%, respectively. Expenditure on antifungals was reduced by US$370681.78 (11.8% reduction). The programme was not related to significant increases in the incidence of candidaemia, percentage of persistent/relapsing candidaemia cases, percentage of fluconazole-resistant Candida species, incidence of infections by filamentous fungi, or 12-month mortality in patients with filamentous fungal infections. In conclusion, a stewardship programme targeting antifungals achieved a reduction in antifungal expenditure without reducing the quality of care provided.

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Section: Introductionmentioning

confidence: 99%

“…New antifungals have slight differences in the spectrum of action, dose required, route of administration, and interactions with other drugs, which are difficult to manage by a non-fungal specialist [3]. Therefore, the need for stewardship programmes targeting antifungals has been raised [3,4].…”

Section: Introductionmentioning

confidence: 99%

A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital

López‐Medrano¹,

Juan²,

Lizasoaín³

et al. 2013

Clinical Microbiology and Infection

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“…As C. albicans is a pathogenic yeast, which is often responsible for human disease in the form of oral infections, vaginitis and invasive infections, the latter being particularly frequent in immunocompromised patients [36], [37], renewed interest in effective vaccines has been spurred by the emergence of resistance to and the relatively high toxicity of antifungal agents [38], [39]. No such vaccine, however is currently available.…”

Section: Discussionmentioning

confidence: 99%

Yeast Killer Toxin-Like Candidacidal Ab6 Antibodies Elicited through the Manipulation of the Idiotypic Cascade

et al. 2014

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A mouse anti-anti-anti-idiotypic (Id) IgM monoclonal antibody (mAb K20, Ab4), functionally mimicking a Wyckerhamomyces anomalus (Pichia anomala) killer toxin (KT) characterized by fungicidal activity against yeasts presenting specific cell wall receptors (KTR) mainly constituted by β-1,3-glucan, was produced from animals presenting anti-KT Abs (Ab3) following immunization with a rat IgM anti-Id KT-like mAb (mAb K10, Ab2). MAb K10 was produced by immunization with a KT-neutralizing mAb (mAb KT4, Ab1) bearing the internal image of KTR. MAb K20, likewise mAb K10, proved to be fungicidal in vitro against KT-sensitive Candida albicans cells, an activity neutralized by mAb KT4, and was capable of binding to β-1,3-glucan. MAb K20 and mAb K10 competed with each other and with KT for binding to C. albicans KTR. MAb K20 was used to identify peptide mimics of KTR by the selection of phage clones from random peptide phage display libraries. Using this strategy, four peptides (TK 1-4) were selected and used as immunogen in mice in the form of either keyhole limpet hemocyanin (KLH) conjugates or peptide-encoding minigenes. Peptide and DNA immunization could induce serum Abs characterized by candidacidal activity, which was inhibited by laminarin, a soluble β-1,3-glucan, but not by pustulan, a β-1,6-glucan. These findings show that the idiotypic cascade can not only overcome the barrier of animal species but also the nature of immunogens and the type of technology adopted.

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“…are the third most common cause of intravascular catheter-related infection, with the second highest colonization-to-infection rate and the overall highest crude mortality. [21] I. orientalis is commonly implicated in urinary tract infections in immunocompromised patients [22,23] while C. neoformans ranks as one of the most common infectious agents that causes human meningoencephalitis (cryptococcosis). [7] The present study shows that the overall antifungal activity screening results are indicative of the potential of these plant extracts as effective medicaments in the treatment of fungal infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

Antifungal and antibacterial properties of three medicinal plants from Malaysia

Shing¹,

Wen²,

Wei³

et al. 2013

Phcog Commn

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Introduction: The increase of opportunistic fungal infections and the escalation of bacterial resistance have seriously reduced the efficacy of chemotherapeutic agents available. Thus the search for new antimicrobial agents from natural sources such as medicinal plants becomes necessary. Methods: The aerial parts of Diplazium esculentum and Sechium edule, and the fruits of Solanum muricatum were used, and extracted sequentially using hexane, chloroform, ethyl acetate, ethanol, methanol, and water. The extracts were then evaluated, in triplicate, against a panel of 12 medically-important microorganisms for microbiostatic and microbiocidal activities using colorimetric broth microdilution methods. Results: The total percentage yield obtained were 1.20%, 1.84% and 3.53% (w/w, based on fresh weight) for D. esculentum, S. edule and S. muricatum, respectively. All plant extracts showed antifungal activity with 66% and 49% of the bioassays demonstrating fungistatic and fungicidal activity, respectively. Two yeasts, Cryptococcus neoformans and Issatchenkia orientalis were found to be susceptible to all extracts. The lowest minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) was exhibited by the hexane extracts of S. edule and S. muricatum against C. neoformans, both with values of 0.08 mg/mL. In the antibacterial screening assays, 49% of the bioassays exhibited bacteriostatic activity while only 21% of them showed bactericidal activity. The lowest MIC and minimum bactericidal concentration (MBC) was recorded for the hexane extract of S. muricatum against Bacillus cereus and Klebsiella pneumoniae, both with values of 0.31 mg/mL. The susceptibility of bacteria towards the plant extracts evaluated was species-dependent, with the susceptibility indices ranging from 0% for Escherichia coli to 72% for Pseudomonas aeruginosa. Conclusions: The results from this study show that extracts from these plants have significant antimicrobial activity, which corroborates their use in traditional medicine.

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New antifungal agents for the treatment of candidaemia

Cited by 12 publications

References 73 publications

A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital

A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital

Yeast Killer Toxin-Like Candidacidal Ab6 Antibodies Elicited through the Manipulation of the Idiotypic Cascade

Antifungal and antibacterial properties of three medicinal plants from Malaysia

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