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Antifungal drugs and rational use of antifungals in treating invasive aspergillosis: the role of the hospital pharmacist

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Abstract

Aim:This review discusses the most common used antifungal agents in the treatment of invasive fungal infections. In addition, guidelines for the treatment of invasive aspergillosis, as used in the Ghent University Hospital, are described. Moreover, the importance of determining the effectiveness of antifungal therapy as well as the potential role of the hospital pharmacist in the management of this infection is highlighted.

Methods:A review of the English-language literature was conducted using the MEDLINE database and scientific websites. Search terms including antimycotics, antifungal therapy and invasive aspergillosis were used to refine the search, and preference was given to studies published after 1992. This was completed with recent treatment guidelines.

Results:An overview of the most recent advances in antifungal therapy is described. In addition, a flowchart for treatment of invasive aspergillosis (proven, probable or possible) has been developed.

Conclusion:Invasive fungal infections will remain a frequent and important complication of modern medicine. Considering the clinical and financial outcome of invasive fungal infections, the role of the hospital pharmacist can be a paramount to the treatment.

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References

  • S Mossad (2003) ArticleTitlePrevention and treatment of fungal infections in bone marrow transplantation. Curr Hematol Rep 2 302–9 Occurrence Handle12901327

    PubMed  Google Scholar 

  • Sanglard D, Bille J. Current understanding of the modes of action of and resistance mechanisms to conventional and emerging antifungal agents for treatment of Candida infections. In: Calderone R, editor. Washington, USA: ASM Press, 2002.

  • AH Groll TJ Walsh (2002) ArticleTitleAntifungal chemotherapy: advances and perspectives. Swiss Med Weekly 132 303–11 Occurrence Handle1:CAS:528:DC%2BD38Xotlant78%3D

    CAS  Google Scholar 

  • Prevention, diagnosis and management of invasive aspergillosis in immunocompromised patients. The Infectious Diseases Advisory Board, 2004. ISBN 90-805936-4-8.

  • RD Meyer (1992) ArticleTitleCurrent role of therapy with amphotericin B. Clin Infect Dis 14(Suppl.1) S154–S160

    Google Scholar 

  • http://www.doctorfungus.org/thedrugs/Nystatin liposomal.htm.

  • CA Lyman TJ Walsh (1992) ArticleTitleSystemically administered antifungal agents. A review of their clinical pharmacology and therapeutic applications. Drugs 44 9–35 Occurrence Handle1:STN:280:By2A283lsFE%3D Occurrence Handle1379913

    CAS  PubMed  Google Scholar 

  • EJ Anaissie DP Kontonyiannis C Huls SE Vartivarian C Karl RA Prince J Bosso GP Bodey (1995) ArticleTitleSafety, plasma concentrations, and efficacy of high-dose fluconazole in invasive mold infections. J Infect Dis 172 599–602 Occurrence Handle1:STN:280:ByqA2cflslc%3D Occurrence Handle7622915

    CAS  PubMed  Google Scholar 

  • J Wheat S MaWhinney R Hafner D McKinsey D Chen A Korzun et al. (1997) ArticleTitleNational institute of allergy and infectious diseases acquired immunodeficiency syndrome clinical trials group and mycoses study group. Treatment of histoplasmosis with fluconazole in patients with acquired immunodeficiency syndrome. Am J Med 103 223–32 Occurrence Handle10.1016/S0002-9343(97)00151-4 Occurrence Handle1:CAS:528:DyaK2sXms1Glu7g%3D Occurrence Handle9316555

    Article  CAS  PubMed  Google Scholar 

  • PG Pappas RW Bradsher CA Kauffman GA Cloud CJ Thomas GD Campbell et al. (1997) ArticleTitleNational institute of allergy and infectious diseases mycoses study group. Treatment of blastomycosis with higher doses of fluconazole. Clin Infect Dis 25 200–205 Occurrence Handle1:CAS:528:DyaK2sXmtVyjtbc%3D Occurrence Handle9332510

    CAS  PubMed  Google Scholar 

  • K Vandewoude D Vogelaers J Decruyenaere P Jaqmin K De Beule A Peer ParticleVan et al. (1997) ArticleTitleConcentrations in plasma and safety of 7 days of intravenous itraconazole followed by 2 weeks of oral itraconazole solution in patients in intensive care units. Antimicrob Agents Chemother 41 2714–8 Occurrence Handle1:CAS:528:DyaK2sXnvFWjsLw%3D Occurrence Handle9420044

    CAS  PubMed  Google Scholar 

  • HH Zhou M Goldman J Wu R Woestenborghs AE Hassell P Lee et al. (1998) ArticleTitleA pharmacokinetic study of intravenous itraconazole followed by oral administration of itraconazole capsules in patients with advanced human immunodeficiency virus infection. J Clin Pharmacol 38 593–602 Occurrence Handle1:CAS:528:DyaK1cXltleisrY%3D Occurrence Handle9702843

    CAS  PubMed  Google Scholar 

  • DJ Sheehan CA Hitchcock CM Sibley (1999) ArticleTitleCurrent and emerging azole antifungal agents. Clin Microbiol Rev 12 40–79 Occurrence Handle1:CAS:528:DyaK1MXpvVOlsw%3D%3D Occurrence Handle9880474

    CAS  PubMed  Google Scholar 

  • D Law CB Moore DW Denning (1997) ArticleTitleActivity of SCH 56592 compared with those of fluconazole and itraconazole against Candida spp. Antimicrob Agents Chemother 41 2310–11 Occurrence Handle1:CAS:528:DyaK2sXms1Snsbk%3D Occurrence Handle9333073

    CAS  PubMed  Google Scholar 

  • http://www.doctorfungus.org/thedrugs/Ravuconazole.htm.

  • FC Odds AJP Brown NAR Gow (2003) ArticleTitleAntifungal agents: mechanisms of action. Trends Microbiol 11 272–79 Occurrence Handle10.1016/S0966-842X(03)00117-3 Occurrence Handle1:CAS:528:DC%2BD3sXkvVCmsLk%3D Occurrence Handle12823944

    Article  CAS  PubMed  Google Scholar 

  • D Denning (2002) ArticleTitleEchinocandins: a new class of antifungals. J Antimicrob Chemother 49 889–91 Occurrence Handle10.1093/jac/dkf045 Occurrence Handle1:CAS:528:DC%2BD38XltVyrsLY%3D Occurrence Handle12039879

    Article  CAS  PubMed  Google Scholar 

  • D Denning (1997) ArticleTitleEchinocandins and pneumocandins: a new antifungal class with a novel mode of action. J Antimicrob Chemoth 40 611–14 Occurrence Handle10.1093/jac/40.5.611 Occurrence Handle1:CAS:528:DyaK2sXnvFWis78%3D

    Article  CAS  Google Scholar 

  • N Wiederhold R Lewis (2003) ArticleTitleThe echinocandin antifungals: an overview of the pharmacology, spectrum and clinical efficacy. Expert Opin Drugs 12 1313–33 Occurrence Handle10.1517/eoid.12.8.1313.21782 Occurrence Handle1:CAS:528:DC%2BD3sXlslShs7g%3D

    Article  CAS  Google Scholar 

  • D Andes M Ogtrop Particlevan (2000) ArticleTitleIn vivo characterization of the pharmacodynamics of fIucytosine in a neutropenic murine disseminated candidiasis model. Antimicrob Agents Chemother 44 938–42 Occurrence Handle10.1128/AAC.44.4.938-942.2000 Occurrence Handle1:CAS:528:DC%2BD3cXitFOlurs%3D Occurrence Handle10722494

    Article  CAS  PubMed  Google Scholar 

  • https://www.inami.fgov.be/.

  • GA Wetzstein (2000) ArticleTitleIntravenous to oral (IV:PO) anti-infective conversion therapy. Cancer Control 7 170–6 Occurrence Handle1:STN:280:DC%2BD3c3ks1amsw%3D%3D Occurrence Handle10783821

    CAS  PubMed  Google Scholar 

  • D Nathwani G Tillotson P Davey (1997) ArticleTitleSequential antimicrobial therapy, the role of quinolones. J Antimicrob Chemother 39 441–6 Occurrence Handle10.1093/jac/39.4.441 Occurrence Handle1:CAS:528:DyaK2sXjtlyhu7Y%3D Occurrence Handle9145815

    Article  CAS  PubMed  Google Scholar 

  • V Von Gunten V Amos A Sidler J Beney N Troillet J Reymond (2003) ArticleTitleHospital pharmacists’ reinforcement of guidelines for switching from parenteral to oral antibiotics: a pilot study. Pharm World Sci 25 IssueID2 52–5 Occurrence Handle10.1023/A:1023240829761 Occurrence Handle12774564

    Article  PubMed  Google Scholar 

  • HM Lazarus JL Blumer S Yanovich H Schlamm A Romero (2002) ArticleTitleSafety and pharmacokinetics of oral voriconazole in patients at risk of fungal infection: a dose escalation study. J Clin Pharmacol 42 IssueID4 395–402 Occurrence Handle10.1177/0091270002424005 Occurrence Handle1:CAS:528:DC%2BD38Xjt1ynsr8%3D Occurrence Handle11936564

    Article  CAS  PubMed  Google Scholar 

  • RB Laing AR Mackenzie H Shaw IM Gould JG Douglas (1998) ArticleTitleThe effect of intravenous-to-oral switch guidelines on the use of parenteral on use antimicrobials in medical wards. J Antimicrob Chemother 42 107–11 Occurrence Handle10.1093/jac/42.1.107 Occurrence Handle1:CAS:528:DyaK1cXltFOqsr4%3D Occurrence Handle9700538

    Article  CAS  PubMed  Google Scholar 

  • A Somers T Bauters H Robays M Bogaert F Colardyn (2002) ArticleTitleEvaluation of human albumin use in a university hospital in Belgium. Pharm World Sci 24 IssueID3 111–6 Occurrence Handle10.1023/A:1016120917510 Occurrence Handle1:CAS:528:DC%2BD38XkvF2gtLY%3D Occurrence Handle12136743

    Article  CAS  PubMed  Google Scholar 

  • D Nathwani K Gray H Borland (2002) ArticleTitleQuality indicators for antibiotic control programmes. J Hosp Infect 50 165–9 Occurrence Handle10.1053/jhin.2001.1171 Occurrence Handle1:STN:280:DC%2BD387lsVyksg%3D%3D Occurrence Handle11886190

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Tiene G. M Bauters.

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Bauters, T.G.M., Buyle, F.M.A., Peleman, R. et al. Antifungal drugs and rational use of antifungals in treating invasive aspergillosis: the role of the hospital pharmacist. Pharm World Sci 27, 31–34 (2005). https://doi.org/10.1007/s11096-004-1735-0

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  • DOI: https://doi.org/10.1007/s11096-004-1735-0

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