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At least 433 records · Page 24Linked to original sources
PubMed2005

[New medications for treatment of systemic mycoses].

The past few years have seen the advent of several new antifungal agents. The echinocandin, caspofungin, has greatly expanded the antifungal armamentarium by providing a cell wall-active agent with candidacidal activity as well as demonstrated clinical efficacy in the therapy of aspergillosis refractory to available therapy. In addition, in clinical trials, caspofungin exhibited efficacy comparable to amphotericin B for invasive and/or fluconazole-resistant Candida infections. According to a randomised trial, voriconazole has added a significantly improved therapeutic option for primary therapy of invasive aspergillosis. Additionally, voriconazole may be used successfully as salvage therapy for other fungal infections, i.e. cryptococcosis. Despite the advances offered by each of these drugs, the morbidity and mortality associated with invasive fungal infections remains high. Considering the adverse effects of the available antifungal agents and the considerable costs for their application, meaningful clinical trials for a precise indication in different clinical situations are urgently needed.

Antifungal Agents↗
PubMed1983

Treatment of mycoses in cancer patients.

Invasive fungal infections are becoming increasingly frequent among immunocompromised patients and especially among cancer patients. The most common pathogens identified are Candida species, Aspergillus species, Cryptococcus neoformans, and Mucor species. Amphotericin B remains the mainstay of antifungal therapy. However, the toxicity of this drug may limit its use and, in addition, both failures and relapses have been reported. 5-Fluorocytosine and imidazoles, such as miconazole and ketoconazole, have been shown to be active, mainly on yeast organisms. The emergence of 5-fluorocytosine-resistant strains warrants caution for its administration as a single agent. The specific role of ketoconazole has not yet been established in large studies. In our experience, ketoconazole seems to be effective in the treatment of severe oral candidiasis in non-neutropenic cancer patients. Moreover, ketoconazole administered prophylactically to neutropenic patients decreases the number of positive surveillance cultures in these patients. The rare incidence of major toxicity and the ability to administer ketoconazole orally represent also major arguments for further investigation of ketoconazole activity by prospective controlled studies.

Amphotericin B↗
PubMed1990

European experience with itraconazole in systemic mycoses.

Since January 1985 more than 100 patients with deep fungal infections have been treated with itraconazole (200 to 400 mg/day) in Northern Italy. Evaluation of the drug efficacy and tolerance was possible in one patient with sporotrichosis, in 34 with aspergillosis, and in 36 with cryptococcosis (mainly patients positive for human immunodeficiency virus). Response to itraconazole alone was obtained in the case of sporotrichosis and in 24 of 34 patients with different forms of aspergillosis (of the 18 patients with invasive pulmonary aspergillosis, 15 were cured). Patients with cryptococcosis received itraconazole for active infection and/or for prevention of relapse. Active infection was treated successfully with itraconazole alone in 9 of 12 patients and with itraconazole plus flucytosine in 8 of 10 patients. Of the 31 patients who received itraconazole maintenance therapy for up to 27 months, 4 (13%) had relapses; 14 (45%) did not have relapses, and decline of serum antigen was detected in 12 of them; and 13 (42%) were completely cured (serum antigen titer dropped to zero). With the exception of hypokalemia in one patient, itraconazole was well tolerated even in patients who received the drug for several months or years.

Antifungal Agents↗
PubMed1996

[Epidemiology of invasive mycoses. Experience of a university hospital center in Paris].

The incidence of opportunistic fungal infections have dramatically increased during the past decades. Data from a retrospective study conducted between January 1992 and December 1994 in Necker-Enfants Malades Hospital and a review of the literature were analyzed to assess the main epidemiological features of these infections. Candidiasis remained largely the most frequent: candidemia and invasive candidiasis were diagnosed in respectively 71 and 11 patients. Candida albicans was the agent the most frequently isolated from these infections. However, its percentage was not over 49.35% in our experience. In at least 13 of 27 cases, candidemia could be related to a colonized indwelling catheter. Though less frequent (24 cases), invasive aspergillosis is of major concern considering its mortality. A wider clinical spectrum was observed with sub-necrotizing aspergillosis reported in non-neutropenic immunocompromised patients (five cases) and invasive aspergillosis in AIDS patients (two cases). Among the 14 cases of cryptococcosis, 11 were diagnosed in AIDS patients whereas the other three were observed in renal transplant recipients. Beside these three major fungal infections, deep immunosuppression, notably induced by bone marrow transplantation, favored the emergence of newly fungal opportunistic agents such as Fusarium sp (two cases), Scedosporium apiospermum (one case) and Trichosporon sp (one case).

Hospitals, University↗
PubMed1993

Intraconazole--a new oral antifungal agent with a very broad spectrum of activity in superficial and systemic mycoses.

Itraconazole is a triazole-derivative antifungal agent with an extremely broad spectrum of action in vitro, in experimental animals in vivo and in clinical trials. When taken orally, itraconazole achieves high and sustained levels of active drug in many tissues, including skin, nail and most deep organs. Its clinical value has been proved in all forms of mycosis affecting the skin and mucous membranes and in onychomycosis. In systemic infections, clinical trials have led to recommendations that itraconazole is the current drug of choice for blastomycosis, histoplasmosis, paracoccidioidomycosis, lymphocutaneous sporotrichosis, chronic disseminated aspergillosis and many cases of phaeohyphomycosis. It is also finding application in deep-seated Candida infections and in cryptococcosis. Its safety profile is extremely good, with very few non-trivial adverse experiences noted in a large series of patients treated and monitored. Itraconazole therefore represents a useful therapeutic advance for the management of most forms of fungal infection.

Administration, Oral↗
PubMed2006

Mycoses in pediatric patients.

For more than 40 years, there has been limited progress in the treatment of invasive fungal infections. There are now numerous nuances to choosing the appropriate antifungal agent. Important advantages have been achieved in understanding the safety, tolerability, and pharmacokinetics of these agents. One of the most important aspects for successful management of pediatric invasive fungal infections is an understanding of the differences in the pharmacokinetics of the drugs in children and adults to offer optimal dosing strategies. Unfortunately there have been few antifungal studies conducted in children. Consequently most information for the pediatrician has been extrapolated from adult data. The breadth of antifungal data in children is expanding, however, with newer studies underway. Through the efforts of dedicated clinicians and collaboration, pediatric indications and dosing strategies will eventually be discovered that directly benefit pediatric patients.

Antifungal Agents↗
PubMed2000

Sertaconazole in the treatment of mycoses: from dermatology to gynecology.

Sertaconazole is a pharmaceutical product in the form of a cream, gel, powder and solution for dermatological use and vaginal cream, tablets and ovules for gynecological use. It is marketed in 24 countries and registered in a further 22. The active ingredient is 2% sertaconazole nitrate. Sertaconazole nitrate is an azole antifungal agent, with notable antifungal activity. Its molecule has a highly lipophilic fragment. This is a review of the efficacy and safety of all pharmaceutical forms of sertaconazole in order to provide data on vaginal sertaconazole for marketing purposes.

Antifungal Agents↗