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Antifungal Combination Eye Drops for Fungal Keratitis Treatment. Pharmaceutics 2022; 15:pharmaceutics15010035. [PMID: 36678663 PMCID: PMC9866460 DOI: 10.3390/pharmaceutics15010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Fungal keratitis (FK) is a corneal mycotic infection that can lead to vision loss. Furthermore, the severity of FK is aggravated by the emergence of resistant fungal species. There is currently only one FDA-approved formulation for FK treatment forcing hospital pharmacy departments to reformulate intravenous drug preparations with unknown ocular bioavailability and toxicity. In the present study, natamycin/voriconazole formulations were developed and characterized to improve natamycin solubility, permanence, and safety. The solubility of natamycin was studied in the presence of two cyclodextrins: HPβCD and HPγCD. The HPβCD was chosen based on the solubility results. Natamycin/cyclodextrin (HPβCD) inclusion complexes characterization and a competition study between natamycin and voriconazole were conducted by NMR (Nuclear Magnetic Resonance). Based on these results, several eye drops with different polymer compositions were developed and subsequently characterized. Permeability studies suggested that the formulations improved the passage of natamycin through the cornea compared to the commercial formulation Natacyn®. The ocular safety of the formulations was determined by BCOP and HET-CAM. The antifungal activity assay demonstrated the ability of our formulations to inhibit the in vitro growth of different fungal species. All these results concluded that the formulations developed in the present study could significantly improve the treatment of FK.
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Sari S, Avci A, Koçak E, Kart D, Sabuncuoğlu S, Doğan İS, Özdemir Z, Bozbey İ, Karakurt A, Saraç S, Dalkara S. Antibacterial azole derivatives: Antibacterial activity, cytotoxicity, and in silico mechanistic studies. Drug Dev Res 2020; 81:1026-1036. [PMID: 33216362 DOI: 10.1002/ddr.21721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/13/2020] [Accepted: 07/03/2020] [Indexed: 01/09/2023]
Abstract
Azole antifungal drugs are commonly used in antifungal chemotherapy. Antibacterial effects of some topical antifungals, such as miconazole and econazole, have lately been revealed, which suggests a promising venue in antimicrobial chemotherapy. In this study, we tested an in-house azole collection with antifungal properties for their antibacterial activity to identify dual-acting hits using the broth microdilution method. The in vitro screen yielded a number of potent derivatives against gram-positive bacteria, Enterococcus faecalis and Staphylococcus aureus. Compound 73's minimum inhibitory concentration (MIC) value less than 1 μg/ml against S. aureus; however, none of the compounds showed noteworthy activity against methicillin-resistant S. aureus (MRSA). All the active compounds were found safe at their MIC values against the healthy fibroblast cells in the in vitro cytotoxicity test. Molecular docking studies of the most active compounds using a set of docking programs with flavohemoglobin (flavoHb) structure, the proposed target of the azole antifungals with antibacterial activity, presented striking similarities regarding the binding modes and interactions between the tested compounds and the antifungal drugs with crystallographic data. In addition to being noncytotoxic, the library was predicted to be drug-like and free of pan-assay interference compounds (PAINS). As a result, the current study revealed several potential azole derivatives with both antifungal and antibacterial activities. Inhibition of bacterial flavoHb was suggested as a possible mechanism of action for the title compounds.
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Affiliation(s)
- Suat Sari
- Department of Pharmaceutical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Ahmet Avci
- Department of Pharmaceutical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Ebru Koçak
- Department of Pharmaceutical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Didem Kart
- Department of Pharmaceutical Microbiology, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Suna Sabuncuoğlu
- Department of Pharmaceutical Toxicology, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - İnci Selin Doğan
- Department of Pharmaceutical Chemistry, Karadeniz Technical University Faculty of Pharmacy, Trabzon, Turkey
| | - Zeynep Özdemir
- Department of Pharmaceutical Chemistry, İnönü University Faculty of Pharmacy, Malatya, Turkey
| | - İrem Bozbey
- Department of Pharmaceutical Chemistry, Erzincan Binali Yıldırım University Faculty of Pharmacy, Erzincan, Turkey
| | - Arzu Karakurt
- Department of Pharmaceutical Chemistry, İnönü University Faculty of Pharmacy, Malatya, Turkey
| | - Selma Saraç
- Department of Pharmaceutical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Sevim Dalkara
- Department of Pharmaceutical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
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Tafelska-Kaczmarek A, Kołodziejska R, Kwit M, Stasiak B, Wypij M, Golińska P. Synthesis, Absolute Configuration, Antibacterial, and Antifungal Activities of Novel Benzofuryl β-Amino Alcohols. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4080. [PMID: 32937873 PMCID: PMC7560283 DOI: 10.3390/ma13184080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/29/2022]
Abstract
A series of new benzofuryl α-azole ketones was synthesized and reduced by asymmetric transfer hydrogenation (ATH). Novel benzofuryl β-amino alcohols bearing an imidazolyl and triazolyl substituents were obtained with excellent enantioselectivity (96-99%). The absolute configuration (R) of the products was confirmed by means of electronic circular dichroism (ECD) spectroscopy supported by theoretical calculations. Selected benzofuryl α-azole ketones were also successfully asymmetrically bioreduced by fungi of Saccharomyces cerevisiae and Aureobasidium pullulans species. Racemic and chiral β-amino alcohols, as well as benzofuryl α-amino and α-bromo ketones were evaluated for their antibacterial and antifungal activities. From among the synthesized β-amino alcohols, the highest antimicrobial activity was found for (R)-1-(3,5-dimethylbenzofuran-2-yl)-2-(1H-imidazol-1-yl)ethan-1-ol against S. aureus ATCC 25923 (MIC = 64, MBC = 96 μg mL-1) and (R)-1-(3,5-dimethylbenzofuran-2-yl)-2-(1H-1,2,4-triazol-1-yl)ethan-1-ol against yeasts of M. furfur DSM 6170 (MIC = MBC = 64 μg mL-1). In turn, from among the tested ketones, 1-(benzofuran-2-yl)-2-bromoethanones (1-4) were found to be the most active against M. furfur DSM 6170 (MIC = MBC = 1.5 μg mL-1) (MIC-minimal inhibitory concentration, MBC-minimal biocidal concentration).
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Affiliation(s)
- Agnieszka Tafelska-Kaczmarek
- Department of Organic Chemistry, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, 7 Gagarin Street, 87-100 Toruń, Poland
| | - Renata Kołodziejska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 24 Karłowicz Street, 85-092 Bydgoszcz, Poland;
| | - Marcin Kwit
- Faculty of Chemistry, Adam Mickiewicz University, 8 Uniwersytetu Poznańskiego Street, 61-614 Poznań, Poland; (M.K.); (B.S.)
| | - Bartosz Stasiak
- Faculty of Chemistry, Adam Mickiewicz University, 8 Uniwersytetu Poznańskiego Street, 61-614 Poznań, Poland; (M.K.); (B.S.)
| | - Magdalena Wypij
- Department of Microbiology, Faculty of Biology and Veterinary Sciences, Nicolaus Copernicus University in Toruń, 1 Lwowska Street, 87-100 Toruń, Poland; (M.W.); (P.G.)
| | - Patrycja Golińska
- Department of Microbiology, Faculty of Biology and Veterinary Sciences, Nicolaus Copernicus University in Toruń, 1 Lwowska Street, 87-100 Toruń, Poland; (M.W.); (P.G.)
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Grzybowski A, Turczynowska M, Schwartz SG, Relhan N, Flynn HW. The Role of Systemic Antimicrobials in the Treatment of Endophthalmitis: A Review and an International Perspective. Ophthalmol Ther 2020; 9:485-498. [PMID: 32613591 PMCID: PMC7406615 DOI: 10.1007/s40123-020-00270-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background The optimal management of patients with endophthalmitis is challenging and includes both intravitreal and, in some cases, systemic antimicrobials. Systemic antimicrobials may be administered either intravenously or orally. In this article we review systemic antimicrobial options currently available for the treatment of types of endophthalmitis and the role of systemic antimicrobials (antibiotics and antifungals) in these treatments. Review While systemic antimicrobials are not universally utilized in the management of endophthalmitis, they may be helpful in some circumstances. The blood–retinal barrier affects the penetration of systemic medications into the posterior segment of the eye differently; for example, moxifloxacin and imipenem cross the blood–retinal barrier relatively easily while vancomycin and amikacin do not. However, inflammation, including endophthalmitis, may disrupt the blood–retinal barrier, enhancing the penetration of systemic agents into the eye. Conclusion Systemic antimicrobials may be particularly beneficial in patients with certain types of endophthalmitis; as such, they are standard treatment in the management of endogenous endophthalmitis (fungal and bacterial) and also widely used for prophylaxis and treatment of open-globe injuries. Although systemic antimicrobials are used in some patients with acute-onset postoperative endophthalmitis following cataract surgery, the literature generally does not support this practice. It is noted that there are currently no randomized clinical trials demonstrating a benefit of systemic antibiotics for any category of endophthalmitis.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Magdalena Turczynowska
- Department of Ophthalmology, Stefan Żeromski Specialist Municipal Hospital, Cracow, Poland
| | - Stephen G Schwartz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nidhi Relhan
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
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Li Y, Zhu C, Wu H, Pan H, Liu H. Kolliphor® HS 15-cyclodextrin Complex for the Delivery of Voriconazole: Preparation, Characterization, and Antifungal Activity. Curr Drug Metab 2020; 21:379-389. [PMID: 32432999 DOI: 10.2174/1389200221666200520085915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/25/2020] [Accepted: 03/20/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study aimed to reduce the amount of sulfobutylether-β-cyclodextrin (SBECD) used in the marketed voriconazole injections to meet the clinical needs of patients with moderate-to-severe renal impairment (creatinine clearance rate <50 mL/min). OBJECTIVE This study found that the surfactant Kolliphor® HS 15 (HS 15) and SBECD had significant synergistic effects on solubilizing voriconazole, and a novel voriconazole complex delivery system (VRC-CD/HS 15) was established. METHODS The complex system was characterized, and its antifungal activity was studied by dynamic light scattering, dialysis bag method, disk diffusion, and broth microdilution. RESULTS Compared with the control, its encapsulation efficiency (90.07±0.48%), drug loading (7.37±0.25%) and zeta potential (-4.36±1.37 mV) were increased by 1.54%, 41.19%, and 296.36%, respectively; its average particle size (13.92±0.00 nm) was reduced by 15.69%, so the complex system had better stability. Simultaneously, its drug release behavior was similar to that of the control, and it was a first-order kinetic model. Antifungal studies indicated that the complex system had noticeable antifungal effects. With the increase of drug concentration, the inhibition zone increased. The minimum inhibitory concentrations of the complex system against Cryptococcus neoformans, Aspergillus niger and Candida albicans were 0.0313 μg/mL, 1 μg/mL and 128 μg/mL, respectively. CONCLUSION It showed a significant inhibitory effect on C. neoformans and had a visible therapeutic effect on Kunming mice infected with C. neoformans. Consequently, VRC-CD/HS 15 had better physicochemical properties and still had an apparent antifungal effect, and was promising as a potential alternative drug for clinical application.
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Affiliation(s)
- Yiqi Li
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.,Chongqing Engineering Research Center for Pharmaceutical Process and Quality Control, Chongqing, 400715, China
| | - Chao Zhu
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.,Chongqing Engineering Research Center for Pharmaceutical Process and Quality Control, Chongqing, 400715, China
| | - Hui Wu
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.,Chongqing Engineering Research Center for Pharmaceutical Process and Quality Control, Chongqing, 400715, China
| | - Hongchun Pan
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.,Chongqing Engineering Research Center for Pharmaceutical Process and Quality Control, Chongqing, 400715, China
| | - Hong Liu
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.,Chongqing Engineering Research Center for Pharmaceutical Process and Quality Control, Chongqing, 400715, China
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Castro MÁ, Gamito AM, Tangarife-Castaño V, Zapata B, Miguel del Corral JM, Mesa-Arango AC, Betancur-Galvis L, San Feliciano A. Synthesis and antifungal activity of terpenyl-1,4-naphthoquinone and 1,4-anthracenedione derivatives. Eur J Med Chem 2013; 67:19-27. [PMID: 23831506 DOI: 10.1016/j.ejmech.2013.06.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/20/2013] [Accepted: 06/04/2013] [Indexed: 11/29/2022]
Abstract
The antifungal evaluation of twenty seven simple and heterocycle-fused prenyl-1,4-naphthoquinones and 1,4-anthracenediones was performed in vitro against human pathogenic yeasts (Candida spp.) and filamentous fungi (Aspergillus spp., Fusarium spp., and Trichophyton spp.). The synthetic strategy used to obtain the quinone derivatives was initially based on the Diels-Alder cycloaddition between myrcene and several p-benzoquinone derivatives, followed by cyclisation of the prenyl side chain in the case of anthracene-1,4-diones. The most promising compounds, displaying MIC values in the low μg/mL range, were those bearing one or two chlorine atoms attached to the quinone ring. Time-kill curves determined for the most potent compounds showed their fungistatic mode of action similar to that of itraconazole.
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Affiliation(s)
- Ma Ángeles Castro
- Departamento de Química Farmacéutica, Facultad de Farmacia, CIETUS-IBSAL. Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain.
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Zhong YL, Gauthier DR, Shi YJ, McLaughlin M, Chung JYL, Dagneau P, Marcune B, Krska SW, Ball RG, Reamer RA, Yasuda N. Synthesis of antifungal glucan synthase inhibitors from enfumafungin. J Org Chem 2012; 77:3297-310. [PMID: 22423625 DOI: 10.1021/jo300046v] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An efficient, new, and scalable semisynthesis of glucan synthase inhibitors 1 and 2 from the fermentation product enfumafungin 3 is described. The highlights of the synthesis include a high-yielding ether bond-forming reaction between a bulky sulfamidate 17 and alcohol 4 and a remarkably chemoselective, improved palladium(II)-mediated Corey-Yu allylic oxidation at the highly congested C-12 position of the enfumafungin core. Multi-hundred gram quantities of the target drug candidates 1 and 2 were prepared, in 12 linear steps with 25% isolated yield and 13 linear steps with 22% isolated yield, respectively.
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Affiliation(s)
- Yong-Li Zhong
- Department of Process Research, Merck Research Laboratories, P.O. Box 2000, Rahway, New Jersey 07065-0900, USA.
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8
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Miyakis S, van Hal S, Ray J, Marriott D. Voriconazole concentrations and outcome of invasive fungal infections. Clin Microbiol Infect 2010; 16:927-33. [DOI: 10.1111/j.1469-0691.2009.02990.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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In vitro antifungal activities of bis(alkylpyridinium)alkane compounds against pathogenic yeasts and molds. Antimicrob Agents Chemother 2010; 54:3233-40. [PMID: 20530227 DOI: 10.1128/aac.00231-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ten bis(alkylpyridinium)alkane compounds were tested for antifungal activity against 19 species (26 isolates) of yeasts and molds. We then determined the MICs and minimum fungicidal concentrations (MFCs) of four of the most active compounds (compounds 1, 4, 5, and 8) against 80 Candida and 20 cryptococcal isolates, in comparison with the MICs of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and caspofungin, using Clinical Laboratory and Standards Institutes broth microdulition M27-A3 (yeasts) or M38-A2 (filamentous fungi) susceptibility protocols. The compounds were more potent against Candida and Cryptococcus spp. (MIC range, 0.74 to 27.9 microg/ml) than molds (0.74 to 59.7 microg/ml). MICs against Exophiala were 0.37 to 5.9 microg/ml and as low as 1.48 microg/ml for Scedosporium but >or=25 microg/ml for zygomycetes, Aspergillus, and Fusarium spp. Compounds 1, 4, 5, and 8 exhibited good fungicidal activity against Candida and Cryptococcus, except for Candida parapsilosis (MICs of >44 mug/ml). Geometric mean (GM) MICs were similar to those of amphotericin B and lower than or comparable to fluconazole GM MICs but 10- to 100-fold greater than those for the other azoles. GM MICs against Candida glabrata were <1 microg/ml, significantly lower than fluconazole GM MICs (P<0.001) and similar to those of itraconazole, posaconazole, and voriconazole (GM MIC range of 0.4 to 1.23 microg/ml). The GM MIC of compound 4 against Candida guilliermondii was lower than that of fluconazole (1.69 microg/ml versus 7.48 microg/ml; P=0.012). MICs against Cryptococcus neoformans and Cryptococcus gattii were similar to those of fluconazole. The GM MIC of compound 4 was significantly higher for C. neoformans (3.83 mug/ml versus 1.81 microg/ml for C. gattii; P=0.015). This study has identified clinically relevant in vitro antifungal activities of novel bisalkypyridinium alkane compounds.
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Laudenbach JM, Epstein JB. Treatment strategies for oropharyngeal candidiasis. Expert Opin Pharmacother 2010; 10:1413-21. [PMID: 19505211 DOI: 10.1517/14656560902952854] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Oropharyngeal candidiasis (OPC) is a common oral disease that may cause oral symptoms, lead to regional infection (e.g., esophageal candidiasis) and increase the risk of systemic fungal infection in the compromised host. OBJECTIVE Critical review of the literature of prevention and therapy. METHODS The literature was reviewed using PubMed, and specific keywords from the MeSH Database were used. RESULTS/CONCLUSION Management of OPC requires that the underlying risk factors of infection be diagnosed and managed whenever possible. Antimicrobials may be provided as topical or systemic therapy. Topical therapies may provide effective management for candidiasis in the non-compromised host and increase the control of colonization in the compromised host. Advances in prevention and management include new agents and improved mechanisms of topical drug delivery.
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Affiliation(s)
- Joel M Laudenbach
- University of Illinois at Chicago College of Dentistry, Department of Oral Medicine and Diagnostic Sciences, 801 South Paulina Street (MC 838), Rm 554A, Chicago, IL 60612, USA.
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Maschmeyer G, Calandra T, Singh N, Wiley J, Perfect J. Invasive mould infections: a multi-disciplinary update. Med Mycol 2010; 47:571-83. [PMID: 19444698 DOI: 10.1080/13693780902946559] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Systemic fungal infections remain a significant cause of mortality in neutropenic and immunocompromised patients, despite advances in their diagnosis and treatment. The incidence of such infections is rising due to the use of intensive chemotherapy regimens in patients with solid tumours or haematological cancers, the increasing numbers of allogeneic haematopoietic stem cell and solid organ transplants, and the use of potent immunosuppressive therapy in patients with autoimmune disorders. In addition, the epidemiology of systemic fungal infections is changing, with atypical species such as Aspergillus terreus and zygomycetes becoming more common. Treatment has traditionally focused on empirical therapy, but targeted pre-emptive therapy in high-risk patients and prophylactic antifungal treatment are increasingly being adopted. New treatments, including lipid formulations of amphotericin B, second-generation broad-spectrum azoles, and echinocandins, offer effective antifungal activity with improved tolerability compared with older agents; the potential impact of these treatments is reflected in their inclusion in current treatment and prophylaxis guidelines. New treatment strategies, such as aerosolized lipid formulations of amphotericin B, may also reduce the burden of mortality associated with systemic fungal infections. The challenge is to identify ways of coupling potentially effective treatments with early and reliable identification of patients at highest risk of infection.
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Affiliation(s)
- Georg Maschmeyer
- Department of Haematology and Oncology, Center for Haematology, Oncology and Radiotherapy, Klinikum Ernst von Bergmann, Potsdam, Germany.
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Fungal infections of the nervous system: Current perspective and controversies in management. Int J Surg 2010; 8:591-601. [DOI: 10.1016/j.ijsu.2010.07.293] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 06/06/2010] [Accepted: 07/21/2010] [Indexed: 01/23/2023]
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13
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Tolkoff-Rubin NE, Rubin RH. Infection in solid organ transplantation. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Quindós G, Carrillo-Muñoz AJ, Eraso E, Cantón E, Pemán J. [In vitro antifungal activity of voriconazole: New data after the first years of clinical experience]. Rev Iberoam Micol 2007; 24:198-208. [PMID: 17874856 DOI: 10.1016/s1130-1406(07)70043-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Voriconazole has been developed to meet the increasing need for new and useful antifungal agents for the treatment of invasive mycoses. This review describes the spectrum of voriconazole antifungal activity based on data from in vitro studies published during the last three years. This survey demonstrates that voriconazole has a broad antifungal spectrum against the most common fungal pathogens being its action fungistatic for Candida and fungicidal for Aspergillus and other filamentous fungi. Overall, more than 95% of all Candida isolates tested are susceptible to voriconazole and less than 3% are resistant. Similar or even better activity rates have been described for Aspergillus, Cryptococcus and most of yeasts and moulds of medical importance. We also discuss the limitations related to the azole cross-resistance observed in some Candida glabrata isolates, the poor activity of voriconazole against Scedosporium prolificans, its activity against fungal biofilms and the great potential usefulness of combination of voriconazole with other antifungal drugs.
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Affiliation(s)
- Guillermo Quindós
- Laboratorio de Micología Médica, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco, Bilbao, Spain.
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