New advances in systemic antifungal therapy
Journal
Journal of Internal Medicine of Taiwan
Journal Volume
12
Journal Issue
3
Pages
132-141
Date Issued
2001
Author(s)
Abstract
With the growing proportion of immunocompromised patients due to cytotoxic chemotherapy, organ transplantation, and AIDS, the number of invasive diseases due to various kinds of fungi has increased gradually during the past years, especially aspergillosis and candidiasis. There are mainly two categories of drugs in systemic antifungal therapy: polyenes, which included amphotericin B deoxycholate and new lipid formulations of amphotericin B; and azoles, which include fluconazole and itraconazole. Intravenous amphotericin B deoxycholate has been the standard therapy for most serious fungal infections since the 1950s. However, many adverse effects, especially nephrotoxicity and infusion-related events, frequently limit its use. Recently, less nephrotoxic lipid formulations have been introduced. They can allow safer delivery of effective doses and exploring escalating doses for less susceptible pathogens or refractory infections. The azole antifungal drugs have revolutionized the therapy of fungal diseases, especially fluconazole and itraconazole. They are well tolerated, orally administered, and have a broad spectrum. These new antifungal agents offer alternative therapy to amphotericin B for many invasive fungal diseases, and in some instances have become the preferred agents for the treatment of less severe, disseminated fungal infection.
Subjects
(Systemic antifungal therapy) Amphotericin B; Amphotericin B (Lipid formulations of amphotericin B) Azoles
SDGs
Other Subjects
amphotericin B cholesterol sulfate; amphotericin B deoxycholate; amphotericin B lipid complex; antifungal agent; antiinfective agent; astemizole; cisapride; cyclosporin; cytochrome P450; digoxin; diphenhydramine; fluconazole; flucytosine; imidazole; itraconazole; ketoconazole; miconazole; paracetamol; pethidine; phenytoin; polyene; pyrrole derivative; rifabutin; rifampicin; tacrolimus; terfenadine; triazolam; triazole; unindexed drug; warfarin; acquired immune deficiency syndrome; antifungal activity; article; aspergillosis; Aspergillus; Blastomyces dermatitidis; Candida; candidiasis; Coccidioides immitis; controlled study; Cryptococcus; cytotoxicity; disease severity; drug activity; drug antagonism; drug delivery system; drug formulation; drug potentiation; drug safety; drug tolerability; drug use; Fusarium; Histoplasma capsulatum; human; immune deficiency; kidney disease; Leishmania; Malassezia furfur; mycosis; organ transplantation; Paracoccidioides brasiliensis; pathogenicity; Sporothrix schenckii; Trichosporon beigelii
Type
journal article