المؤلفون: Ali Akbar Velayati, Tayebeh Farhadi, Seyed Mohammadreza Hashemian

المصدر: Expert Review of Anti-infective Therapy. 18:1213-1220

مصطلحات موضوعية: 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, Critical Care, Critical Illness, 030106 microbiology, Microbiology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Caspofungin, Virology, Intensive care, Humans, Medicine, Candidiasis, Invasive, 030212 general & internal medicine, Intensive care medicine, business.industry, Critically ill, Candidemia, Invasive candidiasis, bacterial infections and mycoses, medicine.disease, Intensive Care Units, Infectious Diseases, chemistry, business

الوصف: Candidemia is the fourth frequent reason of healthcare-related bloodstream infections in critically ill patients. For initial management of (suspected) invasive candidiasis in critically ill patients, usage of an echinocandin, e.g. caspofungin, has been recommended.In this study, characteristics of caspofungin and its use in intensive care unit (ICU) patients are reviewed based on an electronic search using PubMed and Google scholar.Caspofungin is a semisynthetic derivative from pneumocandin B and the first member of the echinocandins that was approved by the U.S. Food and Drug Administration (FDA) to fight fungal infection. Caspofungin inhibits the enzyme β(1,3)-D-glucan synthase of the fungal cell wall resulted in inhibition of the synthesis of β(1,3)-D-glucan. For critically ill patients, inter- and intraindividual variations affect the caspofungin concentration. The incidence rates and densities of candidemia in surgical ICUs may be higher than medical ICUs resulting in a higher burden of candidemia in surgical ICUs. However, the mortality rate in surgical ICU patients with candidemia is higher than that medical ICU patients due to differences in their underlying conditions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6f2221e273c0e75a4b963298f91c257cTest
https://doi.org/10.1080/14787210.2020.1794817Test

المؤلفون: Kanecia O. Zimmerman, Chi D. Hornik, Briana Scott

المصدر: Expert Opinion on Drug Metabolism & Toxicology. 16:605-616

مصطلحات موضوعية: Antifungal Agents, Population, Pharmacology, Toxicology, 030226 pharmacology & pharmacy, Infant, Newborn, Diseases, Flucytosine, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Amphotericin B deoxycholate, medicine, Humans, Candidiasis, Invasive, education, Voriconazole, education.field_of_study, business.industry, Infant, Newborn, Micafungin, Infant, General Medicine, chemistry, 030220 oncology & carcinogenesis, Anidulafungin, Drug Therapy, Combination, Drug Monitoring, Caspofungin, business, Invasive Fungal Infections, Fluconazole, medicine.drug

الوصف: Invasive fungal infections are an important cause of morbidity and mortality in infants, particularly in extreme prematurity. Successful systemic treatment requires consideration of antifungal efficacy, safety, and pharmacokinetics, including optimization of dosing in this population.This review summarizes published pharmacokinetic data on four classes of antifungal agents used in the neonatal population. Alterations in absorption, distribution, drug metabolism and clearance in infants compared to adult populations are highlighted. Additionally, pharmacodynamics, safety, and therapeutic drug monitoring are discussed. Recent advancements in neonatal antifungal pharmacotherapies are examined, with emphasis on clinical application.Over the last two decades, published studies have provided increased knowledge on pharmacokinetic considerations in the neonatal population. Future research should focus on filling in the knowledge gaps that remain regarding the benefits and risks of combination antifungal therapy, the rising use of micafungin for invasive candidiasis given its fungicidal activity against polyene and azole-resistant Candida species and its minimal adverse effect profile, and the need for pharmacokinetic and safety data of broad spectrum triazoles, like voriconazole and posaconazole, in infants. Furthermore, efforts should focus on well-designed trials, including population pharmacokinetic studies, to develop dosing recommendations with subsequent implementation into clinical practice.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::612f8f1e33116a2a71a6666e66eaf81dTest
https://doi.org/10.1080/17425255.2020.1773793Test

المؤلفون: Salim Ait Belkacem, Sherif Kamal, Ahmed Gab Allah Ibrahim, Ramy Kotb, Nadia Boudjerra, Xin Gao, Claudie Charbonneau, Mei Xue, Zohra Kaci, Lobna Shalaby

المصدر: Expert Review of Pharmacoeconomics & Outcomes Research. 19:693-700

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Antifungal Agents, Adolescent, Cost effectiveness, Itraconazole, Cost-Benefit Analysis, Decision Support Techniques, Immunocompromised Host, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Amphotericin B, medicine, Humans, Economic analysis, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, Treatment costs, health care economics and organizations, Aged, Aged, 80 and over, Voriconazole, business.industry, 030503 health policy & services, Health Policy, High mortality, Health Care Costs, General Medicine, Middle Aged, Treatment Outcome, chemistry, Algeria, Egypt, Female, Caspofungin, 0305 other medical science, business, Invasive Fungal Infections, medicine.drug

الوصف: Background: Invasive fungal infections (IFIs) in immunocompromised patients are associated with high mortality and treatment costs. Identifying appropriate, cost-effective treatment strateg...

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ca8281fe8f8cb5783d8b201bcc4d9c05Test
https://doi.org/10.1080/14737167.2019.1604225Test

المؤلفون: Dianne Gardam, Peter Boan

المصدر: Journal of Chemotherapy. 31:137-140

مصطلحات موضوعية: 0301 basic medicine, Antifungal, medicine.medical_specialty, Antifungal Agents, Candida parapsilosis, Echinocandin, medicine.drug_class, 030106 microbiology, Microbial Sensitivity Tests, Microbiology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Drug Resistance, Fungal, Epidemiology, Prevalence, Humans, Medicine, Pharmacology (medical), Candida albicans, Retrospective Studies, Pharmacology, biology, Candida glabrata, business.industry, Mortality rate, Australia, Candidemia, biochemical phenomena, metabolism, and nutrition, equipment and supplies, bacterial infections and mycoses, biology.organism_classification, Infectious Diseases, Oncology, chemistry, 030220 oncology & carcinogenesis, Caspofungin, business, Fluconazole, medicine.drug

الوصف: Candidemia is a common invasive fungal infection with a high mortality rate. We performed a retrospective audit of candidemia at a tertiary centre in Western Australia, 2005-2014. There were 167 episodes of candidemia due to 173 isolates of Candida. Candida albicans (40.5%), Candida glabrata complex (30.6%), Candida parapsilosis complex (14.4%) were the most common species causing candidemia across the study. Of the tested isolates, 17.7% (11/62) were non-susceptible to fluconazole and 13.6% (9/66) non-susceptible to caspofungin. 22.8% (8/35) C. glabrata complex were fluconazole resistant and 17.1% (6/35) were non-susceptible to caspofungin. Candida glabrata complex was more common in the latter time period, but there were no susceptibility changes over time. In our setting, the prevalence of C. glabrata complex and antifungal non-susceptibility is high, and the prevalence of C. glabrata complex is increasing.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0222eda016a522c71403630f8efd55d8Test
https://doi.org/10.1080/1120009x.2019.1595895Test

المؤلفون: Hai-Rong Lv, Xue-mei Lin, Li Geng, Qi Deng, Ming-Feng Zhao, Yu-ming Li

المصدر: Current Medical Research and Opinion. 34:1209-1216

مصطلحات موضوعية: Adult, Male, 0301 basic medicine, China, medicine.medical_specialty, Antifungal Agents, Itraconazole, 030106 microbiology, Antineoplastic Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Internal medicine, Amphotericin B, Epidemiology, medicine, Humans, In patient, 030212 general & internal medicine, Intensive care medicine, Aged, Retrospective Studies, Voriconazole, Hematology, business.industry, General Medicine, Middle Aged, Treatment Outcome, Invasive fungal disease, chemistry, Hematologic Neoplasms, Female, Symptom Assessment, Caspofungin, business, Invasive Fungal Infections, medicine.drug

الوصف: Empirical antifungal therapy is effective in some patients with risk factors for invasive fungal disease (IFD) who do not qualify for the EORTC/MSG criteria for IFD, but who fail to respond to anti-bacterial and anti-viral therapy.This retrospective single-center study investigated the epidemiology of IFD and empirical antifungal therapy in patients with hematological malignancies.This study recruited 893 patients with hematologic malignancies who had failed to respond to anti-bacterial and anti-viral treatment and received antifungal therapy, but not for antifungal prophylaxis. Antifungal therapy regimens included amphotericin B, voriconazole, itraconazole and caspofungin. A total of 689 patients were diagnosed with proven, probable, or possible IFD, while 159 patients did not meet the EORTC/MSG criteria for IFD diagnosis but recovered with antifungal treatment, and 45 were excluded from having IFD. Effective treatment was defined as the disappearance or resolution of clinical symptoms of IFD.Patients diagnosed with IFD underwent chemotherapy at a higher proportion, and had significantly higher neutrophil counts compared to those who did not qualify for the EORTC/MSG criteria for IFD but responded to antifungals. The mortality due to all causes within 3 months was significantly higher for patients diagnosed with proven IFD, compared with those who did not qualify for the EORTC/MSG criteria for IFD. There was no discontinuation reported due to adverse events of caspofungin.Empirical antifungal treatment could help save the lives of some patients with severe infections who are strongly suspected of having IFD.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bd21dda3e0ace07239a1c46345118c91Test
https://doi.org/10.1080/03007995.2017.1386167Test

المؤلفون: David Creytens, Philip Vlummens, Eva Steel, Anke Delie

المصدر: Acta Clinica Belgica. 72:352-356

مصطلحات موضوعية: Male, 0301 basic medicine, medicine.medical_specialty, Posaconazole, Antifungal Agents, medicine.medical_treatment, 030106 microbiology, Disease, Injections, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Diabetes mellitus, Amphotericin B, medicine, Dermatomycoses, Humans, Hypoglycemic Agents, Insulin, Mucormycosis, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Leukemia, Myeloid, Acute, Diabetes Mellitus, Type 2, chemistry, Toxicity, Zygomycosis, Caspofungin, business, medicine.drug

الوصف: We present a case of cutaneous mucormycosis in a patient with several important risk factors precipitating disease, namely underlying acute myeloid leukaemia and poorly controlled secondary diabetes. Inoculation was most likely caused by repeated minor trauma (insulin injection) at the site of infection. Treatment consisted of surgical debridement and liposomal Amphotericin B (LAmB) during 71 days. Posaconazole had already been initiated prior to infection as primary antifungal prophylaxis but was discontinued during follow-up as susceptibility testing later revealed resistance to posaconazole. Additional treatment with caspofungin and G-CSF was associated because of poor initial result to treatment. Caspofungin was later continued as monotherapy when LAmB had to be interrupted because of renal toxicity. Treatment was completed after closure of the surgical site. The patient was successfully treated and remains infection free for one year after initial diagnosis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4010848c8f70580570329c770b527331Test
https://doi.org/10.1080/17843286.2016.1266802Test

المؤلفون: David A. Stevens, Jessica C Song

المصدر: Critical Reviews in Microbiology. 42:813-846

مصطلحات موضوعية: 0301 basic medicine, Drug, Antifungal Agents, Echinocandin, media_common.quotation_subject, 030106 microbiology, Treatment outcome, Biology, Pharmacology, Applied Microbiology and Biotechnology, Microbiology, Echinocandins, Lipopeptides, 03 medical and health sciences, chemistry.chemical_compound, Pharmacokinetics, Caspofungin, polycyclic compounds, medicine, Animals, Humans, Economics, Pharmaceutical, Dosing, media_common, Clinical Trials as Topic, Fungi, General Medicine, bacterial infections and mycoses, Treatment Outcome, Mycoses, chemistry, Pharmacodynamics, medicine.drug

الوصف: Over the past decade, echinocandins have emerged as first-line antifungal agents for many Candida infections. The echinocandins have a unique mechanism of action, inhibiting the synthesis of β-1,3-d-glucan polymers, key components of the cell wall in pathogenic fungi. Caspofungin was the first echinocandin antifungal agent to become licensed for use. The objectives of this review are to summarize the existing published data on caspofungin, under the subject headings of chemistry and mechanism of action, spectrum of activity, pharmacodynamics, pharmacokinetics, clinical studies, safety, drug interactions, dosing, and an overview of the drug's current place in therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a9519bb34bab9cae5f5caeb97e9b6823Test
https://doi.org/10.3109/1040841x.2015.1068271Test

المؤلفون: William J. Steinbach, Frédéric Lamoth, Praveen R. Juvvadi

المصدر: Critical reviews in microbiology

مصطلحات موضوعية: Antifungal Agents, Intracellular Space, Aspergillosis, Applied Microbiology and Biotechnology, Microbiology, Aspergillus fumigatus, chemistry.chemical_compound, Drug Resistance, Fungal, Stress, Physiological, Heat shock protein, polycyclic compounds, medicine, Animals, Humans, HSP90 Heat-Shock Proteins, Candida albicans, Microbial Viability, biology, General Medicine, biology.organism_classification, medicine.disease, Hsp90, 3. Good health, Protein Transport, chemistry, Chaperone (protein), biology.protein, Caspofungin, Carrier Proteins, Protein Processing, Post-Translational, Echinocandins, Protein Binding

الوصف: Invasive aspergillosis is a life-threatening and difficult to treat infection in immunosuppressed patients. The efficacy of current anti-Aspergillus therapies, targeting the cell wall or membrane, is limited by toxicity (polyenes), fungistatic activity and some level of basal resistance (echinocandins), or the emergence of acquired resistance (triazoles). The heat shock protein 90 (Hsp90) is a conserved molecular chaperone involved in the rapid development of antifungal resistance in the yeast Candida albicans. Few studies have addressed its role in filamentous fungi such as Aspergillus fumigatus, in which mechanisms of resistance may differ substantially. Hsp90 is at the center of a complex network involving calcineurin, lysine deacetylases (KDAC) and other client proteins, which orchestrate compensatory repair mechanisms of the cell wall in response to the stress induced by antifungals. In A. fumigatus, Hsp90 is a trigger for resistance to high concentrations of caspofungin, known as the paradoxical effect. Disrupting Hsp90 circuitry by different means (Hsp90 inhibitors, KDAC inhibitors and anti-calcineurin drugs) potentiates the antifungal activity of caspofungin, thus representing a promising novel antifungal approach. This review will discuss the specific features of A. fumigatus Hsp90 and the potential for antifungal strategies of invasive aspergillosis targeting this essential chaperone.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b24f786cf2033d31570816b3f3e91b95Test
https://doi.org/10.3109/1040841x.2014.947239Test

المؤلفون: Nathalie Grace Chua, Pushpalatha Bangalore Lingegowda, Yvonne Peijun Zhou, Andrea L. Kwa, Winnie Lee

المصدر: Scandinavian Journal of Infectious Diseases. 46:809-812

مصطلحات موضوعية: Microbiology (medical), Antifungal Agents, Echinocandin, Anidulafungin, Echinocandins, Lipopeptides, chemistry.chemical_compound, Caspofungin, hemic and lymphatic diseases, Eosinophilia, polycyclic compounds, medicine, Humans, Adverse effect, Aged, General Immunology and Microbiology, business.industry, General Medicine, respiratory system, bacterial infections and mycoses, respiratory tract diseases, Discontinuation, Organ damage, Infectious Diseases, chemistry, Immunology, Female, medicine.symptom, business, medicine.drug

الوصف: Drug-induced eosinophilia is difficult to diagnose. Severe organ damage can occur if it is left untreated. Presently, caspofungin is the only echinocandin that has been reported to cause eosinophilia. A patient who developed eosinophilia after exposure to caspofungin and re-challenge with anidulafungin is presented. Eosinophilia resolved upon discontinuation of both drugs.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d5c122733206a092d17b04cea298e01aTest
https://doi.org/10.3109/00365548.2014.938692Test

المؤلفون: Elisa Borghi, Rita Sciota, Stefano Andreoni, Daniela Cirasola, Giulia Morace, Valentina Ricucci

المصدر: Journal of Chemotherapy. 26:32-36

مصطلحات موضوعية: Antifungal, Antifungal Agents, Saccharomyces cerevisiae Proteins, medicine.drug_class, Candida glabrata, Microbial Sensitivity Tests, Moths, Polymerase Chain Reaction, Microbiology, Echinocandins, chemistry.chemical_compound, Drug Resistance, Fungal, In vivo, medicine, Animals, Humans, Pharmacology (medical), DNA, Fungal, Fungemia, Pharmacology, Invertebrate host, biology, Candidiasis, Membrane Proteins, bacterial infections and mycoses, biology.organism_classification, medicine.disease, Survival Rate, Galleria mellonella, Disease Models, Animal, Infectious Diseases, Oncology, chemistry, Glucosyltransferases, Larva, Mutation, Caspofungin

الوصف: Although there has been an overall good coverage of Candida glabrata infections by the echinocandins, emergence of antifungal resistance during therapy has been reported. We investigated, by using an invertebrate host model, the fitness of sequential C. glabrata isolates with different echinocandins susceptibility patterns. The studied strains were isolated from a case of recurrent fungemia with a fatal outcome due to C. glabrata that developed cross-resistance to echinocandins during caspofungin therapy. The sequential strains isolated post-therapy showed a S663P mutation in the Fks2p hot spot 1. In vivo study in the invertebrate host Galleria mellonella did not suggest a fitness cost related to the acquired antifungal resistance, the three isolates displayed a similar rate of killing (P = 0.54). We observed a clear correlation between emergence of antifungal resistance and persistence of the causal agent, probably aided by the unchanged fitness and unresponsiveness in vivo to the adopted therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::208018e3a5be9f48ce8f62d378e7ca31Test
https://doi.org/10.1179/1973947813y.0000000100Test