Article
Medicine, General & Internal
Johan A. Maertens, Galia Rahav, Dong-Gun Lee, Alfredo Ponce-de-Leon, Isabel Cristina Ramirez Sanchez, Nikolay Klimko, Anne Sonet, Shariq Haider, Juan Diego Velez, Issam Raad, Liang-Piu Koh, Meinolf Karthaus, Jianying Zhou, Ronen Ben-Ami, Mary R. Motyl, Seongah Han, Anjana Grandhi, Hetty Waskin
Summary: Posaconazole was non-inferior to voriconazole in terms of all-cause mortality up to day 42 in patients with invasive aspergillosis. Posaconazole was well tolerated with fewer treatment-related adverse events compared to voriconazole in the study, supporting its use as a first-line treatment for the condition.
Review
Microbiology
David S. McKinsey
Summary: Histoplasmosis can cause life-threatening infection in untreated HIV patients, but can be effectively managed with antifungal therapy and adherence to proper treatment regimens. Initiating antiretroviral therapy alongside antifungal treatment is crucial for improving outcomes and reducing the risk of relapse. Limited exposure to potential sources of infection and strict adherence to antiretroviral therapy are key strategies to prevent histoplasmosis.
Review
Microbiology
Alice J. Hsu, Pranita D. Tamma, Brian T. Fisher
Summary: This review discusses the role of voriconazole and other drugs in the treatment of invasive aspergillosis in children, as well as the importance of therapeutic drug monitoring.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Veterinary Sciences
Lisa F. Shubitz, Sallianne Schlacks, Polina Vishkautsan, Christine D. Butkiewicz, Kate A. Worthing
Summary: Posaconazole can be an effective treatment option for dogs with refractory coccidioidomycosis, with most dogs showing recovery or clinical remission. Monitoring of liver function and therapeutic drug levels is essential to prevent hepatotoxicity.
JOURNAL OF VETERINARY INTERNAL MEDICINE
(2021)
Review
Dermatology
Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Valliappan Muthu, Ashutosh Nath Aggarwal, Arunaloke Chakrabarti, Ritesh Agarwal
Summary: Oral itraconazole may be preferred over other azoles as initial therapy for CPA, while intravenous echinocandins and voriconazole may be preferred over amphotericin B in treating CPA. Randomised-controlled trials comparing different AFAs, especially newer AFAs, are urgently needed.
Article
Mycology
Zhimin Duan, Jianbo Tong, Nana Zheng, Rong Zeng, Yuzhen Liu, Min Li
Summary: This study evaluated the efficacy of combining the antiarrhythmic drug AMD with triazole drugs for Aspergillus spp. infection. The results showed that the combination of AMD with itraconazole or posaconazole had synergistic fungicidal effects on Aspergillus biofilms.
Article
Immunology
Kaitlin Benedict, Jeremy A. W. Gold, Mitsuru Toda, George R. Thompson, Nathan P. Wiederhold, Dallas J. Smith
Summary: Antifungal therapeutic drug monitoring (TDM) is recommended for hospitalized patients receiving itraconazole, posaconazole, or voriconazole. However, a study found that TDM was only performed in 15.8% of eligible patients, indicating missed opportunities to optimize drug therapy.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Review
Infectious Diseases
Monica A. Slavin, Yee-Chun Chen, Catherine Cordonnier, Oliver A. Cornely, Manuel Cuenca-Estrella, J. Peter Donnelly, Andreas H. Groll, Olivier Lortholary, Francisco M. Marty, Marcio Nucci, John H. Rex, Bart J. A. Rijnders, George R. Thompson, Paul E. Verweij, P. Lewis White, Ruth Hargreaves, Emma Harvey, Johan A. Maertens
Summary: Invasive aspergillosis is an acute infection that primarily affects immunocompromised patients. When primary treatment fails, changing antifungal therapy is recommended based on specific criteria related to mycological testing, increasing galactomannan levels, clinical deterioration, or progression of original lesions.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Review
Pharmacology & Pharmacy
Erin K. K. McCreary, Matthew R. R. Davis, Navaneeth Narayanan, David R. R. Andes, Dario Cattaneo, Robbie Christian, Russell E. E. Lewis, Kevin M. M. Watt, Nathan P. P. Wiederhold, Melissa D. D. Johnson
Summary: Triazole antifungals are commonly used in clinical practice to prevent or treat invasive fungal infections. Therapeutic drug monitoring is necessary due to their variable pharmacokinetics and established relationships between exposure and response.
Article
Immunology
Wen -Kai Chu, Un-In Wu, Tai-Fen Lee, Aristine Cheng, Kai -Hsiang Chen, Kuan-Yin Lin, Yee-Chun Chen
Summary: Amphotericin B and itraconazole are the primary agents for treating histoplasmosis. Newer azoles are alternatives for patients refractory to or intolerant of standard therapy.
JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION
(2023)
Article
Microbiology
Kaiwen Zhuang, Yaling Dai, Yike Zhou, Yujing Ke, Xin Ran, Yuping Ran
Summary: This is a case report of a 47-year-old male patient with cutaneous-disseminated sporotrichosis. Initial antifungal treatment showed unsatisfactory results, but the patient experienced slow improvement with voriconazole treatment. The patient briefly discontinued voriconazole for economic reasons, leading to lesion recurrence. Eventually, rapid improvement was achieved with potassium iodide treatment.
FRONTIERS IN MICROBIOLOGY
(2022)
Article
Ophthalmology
Praneetha Thulasi, Hajirah N. Saeed, Christopher J. Rapuano, Joshua H. Hou, Alpheus B. Appenheimer, James Chodosh, Joann J. Kang, Amber M. Morrill, Neil Vyas, Michael E. Zegans, Richard Zuckerman, Elmer Y. Tu
Summary: Oral miltefosine is a generally well-tolerated treatment adjuvant for patients with refractory Acanthamoeba keratitis, leading to significant improvement in visual acuity. Clinicians should be prepared for the steroid-responsive inflammatory response commonly encountered during treatment.
AMERICAN JOURNAL OF OPHTHALMOLOGY
(2021)
Article
Immunology
Kaitlin Benedict, Jeremy A. W. Gold, Susan E. Beekmann, Philip M. Polgreen, Mitsuru Toda, Dallas J. Smith
Summary: A survey of 523 infectious disease specialists found that a significant number of experts utilize antifungal therapeutic drug monitoring during treatment, but the usage is lower during prophylaxis. The long turnaround times for testing and logistical difficulties are common barriers to the implementation of therapeutic drug monitoring.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Article
Immunology
M. Hong Nguyen, Luis Ostrosky-Zeichner, Peter G. Pappas, Thomas J. Walsh, Joseph Bubalo, Barbara D. Alexander, Marisa H. Miceli, Jeanette Jiang, Yi Song, George R. Thompson
Summary: This study assessed the real-world use of mold-active triazoles (MATs) for the prevention of invasive fungal diseases (IFDs) and found that MATs were effective in preventing IFDs and had a low discontinuation rate due to adverse drug reactions (ADRs).
OPEN FORUM INFECTIOUS DISEASES
(2023)
Article
Infectious Diseases
Chunrong Ju, Qiaoyan Lian, Ao Chen, Boxin Zhao, Shouning Zhou, Yuhang Cai, Hui Xie, Li Wei, Shiyue Li, Jianxing He
Summary: This study compared the antifungal prophylactic effectiveness and drug concentrations of voriconazole and posaconazole in lung transplant recipients. The results showed that posaconazole had higher levels in bronchoalveolar lavage fluid (BALF) compared to voriconazole, while the plasma levels were comparable. There was no significant difference in breakthrough invasive fungal diseases (IFDs) between the two groups. Overall, posaconazole had higher intrapulmonary concentrations and the two agents had similar antifungal prophylactic effectiveness.