Recommendations for the treatment of fungal pneumonias.
Incidences of fungal pneumonias have increased in immunocompromised patients with HIV infection or receiving bone marrow replacement or solid organ transplantation. Fungal pneumonias including aspergillosis, cryptococcosis, candidiasis, coccidioidomycosis, histoplasmosis and blastomycosis are one of the major causes of morbidity and mortality among the immunosuppressed hosts. Therefore, clinicians should consider the most appropriate and aggressive treatment of fungal pneumonias in this population. This report outlines the state of the art in the treatment of fungal pneumonias and discusses recent advances in antifungal therapy. Practice guidelines for the treatment with commonly used antifungal agents including amphotericin B, fluconazole, itraconazole, ketoconazole and flucytosine, are very useful for clinicians to manage the diseases appropriately. Echinocandins and second-generation triazoles will hopefully help clinicians to overcome the limitations of the current therapy.
Yamada
Harumi
H
Pharmacy Division, Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan.
Kotaki
Hajime
H
Takahashi
Takashi
T
D000818:Animals; D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000188:drug therapy; D001759:Blastomycosis / Q000188:drug therapy; D002177:Candidiasis / Q000188:drug therapy; D003047:Coccidioidomycosis / Q000188:drug therapy; D003453:Cryptococcosis / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications; D006660:Histoplasmosis / Q000188:drug therapy; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000382:microbiology; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology
D000935:Antifungal Agents