Overview of treatment options for invasive fungal infections

Pound, M. W.; Townsend, Mary L.; DiMondi, V. Paul; Wilson, Dustin; Drew, Richard H.

doi:10.3109/13693786.2011.560197

Cited by 43 publications

(47 citation statements)

References 210 publications

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“…grew concomitant Mucorales (Table 4). This highlights the pathogenic nature of these other molds and supports the clinical practice of early empirical therapy with both liposomal amphotericin B and voriconazole, as potential copathogenic molds are not uniformly sensitive to amphotericin B (22,23).…”

Section: Discussionmentioning

confidence: 81%

Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections

et al. 2015

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Section: Discussionmentioning

confidence: 81%

Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections

et al. 2015

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“…Toxicity associated with 5FC includes hepatitis and myelosuppression, especially at serum concentrations 4100 mg/mL. Polyene antifungals exhibit dose-related nephrotoxicity which is reduced with newer lipid formulations of AmB compared to conventional AmB deoxycholate 2,68 . Polyenes have also been linked with common infusionrelated reactions and less frequently anemia.…”

Section: Drug Interactions and Toxicitymentioning

confidence: 99%

“…Toxicities associated with antifungal agents can also impact drug choice and monitoring 1,2,5,7,64,67 . Toxicity associated with 5FC includes hepatitis and myelosuppression, especially at serum concentrations 4100 mg/mL.…”

Section: Drug Interactions and Toxicitymentioning

confidence: 99%

“…Furthermore, polyene-related nephrotoxicity increases the risk of serious 5FC-related adverse events such as bone marrow suppression when polyenes are coadministered with this 5FC 69,70 . Triazoles are generally safe and well tolerated 2,68 . The most common side effects are gastrointestinal.…”

Section: Drug Interactions and Toxicitymentioning

confidence: 99%

“…5-fluorocytosine (5FC, also known as flucytosine), a pyrimidine analog 1,2 . Additional agents are in development 3,4 .…”

mentioning

confidence: 99%

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Optimizing antifungal choice and administration

Andes¹

2013

Current Medical Research and Opinion

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Primary antifungal prophylaxis for cryptococcal disease in HIV-positive people

Awotiwon

Johnson

Rutherford

et al. 2018

Cochrane Database of Systematic Reviews

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Background Cryptococcal disease remains one of the main causes of death in HIV‐positive people who have low cluster of differentiation 4 (CD4) cell counts. Currently, the World Health Organization (WHO) recommends screening HIV‐positive people with low CD4 counts for cryptococcal antigenaemia (CrAg), and treating those who are CrAg‐positive. This Cochrane Review examined the effects of an approach where those with low CD4 counts received regular prophylactic antifungals, such as fluconazole. Objectives To assess the efficacy and safety of antifungal drugs for the primary prevention of cryptococcal disease in adults and children who are HIV‐positive. Search methods We searched the CENTRAL, MEDLINE PubMed, Embase OVID, CINAHL EBSCOHost, WHO International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, conference proceedings for the International AIDS Society (IAS) and Conference on Retroviruses and Opportunistic Infections (CROI), and reference lists of relevant articles up to 31 August 2017. Selection criteria Randomized controlled trials of adults and children, who are HIV‐positive with low CD4 counts, without a current or prior diagnosis of cryptococcal disease that compared any antifungal drug taken as primary prophylaxis to placebo or standard care. Data collection and analysis Two review authors independently assessed eligibility and risk of bias, and extracted and analysed data. The primary outcome was all‐cause mortality. We summarized all outcomes using risk ratios (RR) with 95% confidence intervals (CI). Where appropriate, we pooled data in meta‐analyses. We assessed the certainty of the evidence using the GRADE approach. Main results Nine trials, enrolling 5426 participants, met the inclusion criteria of this review. Six trials administered fluconazole, while three trials administered itraconazole. Antifungal prophylaxis may make little or no difference to all‐cause mortality (RR 1.07, 95% CI 0.80 to 1.43; 6 trials, 3220 participants; low‐certainty evidence). For cryptococcal specific outcomes, prophylaxis probably reduces the risk of developing cryptococcal disease (RR 0.29, 95% CI 0.17 to 0.49; 7 trials, 5000 participants; moderate‐certainty evidence), and probably reduces deaths due to cryptococcal disease (RR 0.29, 95% CI 0.11 to 0.72; 5 trials, 3813 participants; moderate‐certainty evidence). Fluconazole prophylaxis may make no clear difference to the risk of developing clinically resistant Candida disease (RR 0.93, 95% CI 0.56 to 1.56; 3 trials, 1198 participants; low‐certainty evidence); however, there may be an increased detection of fluconazole‐resistant Candida isolates from surveillance cultures (RR 1.25, 95% CI 1.00 to 1.55; 3 trials, 539 participants; low‐certainty evidence). Antifungal prophylaxis was generally well‐tolerated with probably no clear...

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Overview of treatment options for invasive fungal infections

Cited by 43 publications

References 210 publications

Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections

Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections

Optimizing antifungal choice and administration

Primary antifungal prophylaxis for cryptococcal disease in HIV-positive people

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