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PubMed1981

[New pharmaceuticals in systemic mycoses (author's transl)].

The chemotherapy of systemic fungal infections remains problematic due to a lack of alternative agents. There are only 3 drugs available: Amphotericin B, 5-Fluorcytosine and the new iv.-formulation of Miconazole. There are as yet limited experiences concerning one of the Imidazole-derivatives of the new generation, Ketoconazole. The main antimycotic and pharmacokinetic properties of these drugs will be discussed.

Amphotericin B↗
PubMed1978

[Some human mycoses].

The increase in cases of mycosis, especially those due to "opportunistic fungi", is examined. Reference is made to some rare cases of infection that appear to show that some fungi not usually regarded as pathogenic, but merely as parasites of animals and plants, now tend to result in human infection. Various clinical and epidemiological features of "deep mycosis" caused by fungi with dimorphism are also discussed.

Aspergillosis↗
PubMed1994

[Mycoses in oncologic patients].

Lately the frequency of fungal infections in oncological patients considerably increased. The cause is a decreased immune status and in particular decreased immunity against fungal infections in oncological patients because of the oncological disease and aggressive treatment. In the patients treated with immunodepressants the frequency of Candida vegetating on the skin and in open cavities was higher. Fungi were isolated from the pathological materials of 8.9 per cent of the patients in 1981, 12 per cent in 1990, 17 per cent in 1991 and 24 per cent in 1992. Candida were more frequent than other taxa. The frequency of Candida amounted to 92-97 per cent of all the fungal isolates. This stipulated for the necessity of not only an adequate use of antimycotics in the treatment of fungal infections and more often mixed bacterial and fungal infections but also the prophylaxis of fungal infections.

Candidiasis↗
PubMed1994

[Intravenous amphotericin B as prevention of deep mycoses in allogeneic bone marrow transplantation].

BACKGROUND: To evaluate the efficacy of i.v. amphotericin B (AmB) as prophylaxis of deep mycosis (DM) in allogenic bone marrow transplantation (BMT). METHODS: From July 1991 to May 1993, 45 consecutive patients treated by allogenic BMT with no previous history of systemic mycosis and with normal renal function were administered prophylactic AmB at a dose of 0.5 mg/kg/48 h from day + 1 BMT until hemoperipheral recovery (group A). These were compared with an historic control group made up of 45 consecutive patients submitted to BMT from January 1990 to June 1991 who did not receive prophylactic AmB (group B). During the neutropenic phase all the patients remained in isolation units with laminar flow of filtered air and were administered oral non absorbable antibiotic therapy and diet of low bacterial content. The incidence of DM and the dose of AmB administered during the first 120 days post BMT were evaluated. RESULTS: In the first 30 days following BMT 3 (7%) cases of DM were observed in group A and 3 (7%) in group B. Four (9%) additional cases were found from days 30 to 120 in group A and 3 (7%) in group B. In 3 (7%) patients of the group which received prophylaxis and in 4 (9%) of the control group Candida spp. was isolated. In 3 (7%) patients from group A and 1 (2%) patient from group B the infection was due to Aspergillus. Although the patients from group A received therapeutic AmB less frequently (78% vs 91%) and later (13 [SD +/- 5.9] vs 9.2 [SD +/- 4.6] days) than those of group B (p < 0.002) the mean dose of AmB per patient treated was similar in both groups (11.3 [SD +/- 8.8] vs 11.8 [SD +/- 7] mg/kg). CONCLUSIONS: The prophylactic use of systemic amphotericin during the neutropenic phase of bone marrow transplantation does not reduce either the incidence of deep mycosis or the mean dose of amphotericin administered.

Adolescent↗