Use of newer antifungal therapies in clinical practice: what do the data tell us?
Considering the significant morbidity and mortality associated with invasive fungal infections in immunocompromised patients, it is particularly important to make the diagnosis as early as possible and to make best use of the available antifungal drugs for prophylaxis and treatment. The newer antifungal drugs include the lipid products of amphotericin B, such as amphotericin B lipid complex (ABLC) and liposomal amphotericin B; voriconazole (a triazole); and caspofungin (an echinocandin). ABLC and liposomal amphotericin B are as effective as amphotericin B deoxycholate but are less nephrotoxic; ABLC is probably the drug of choice for zygomycosis. Voriconazole is approved for use in the treatment of invasive aspergillosis and may have a role in preventing breakthrough fungal infections in patients with persistent fever and neutropenia. Caspofungin is effective against both invasive aspergillosis and invasive candidiasis.
Perfect
John R
JR
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina 27710, USA.
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy; D002177:Candidiasis / Q000188:drug therapy; D000077336:Caspofungin; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004338:Drug Combinations; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D006801:Humans; D055666:Lipopeptides; D008081:Liposomes; D009181:Mycoses / Q000188:drug therapy*; D010456:Peptides, Cyclic / Q000627:therapeutic use; D010713:Phosphatidylcholines / Q000627:therapeutic use; D010715:Phosphatidylglycerols / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole; D020096:Zygomycosis / Q000188:drug therapy
D000935:Antifungal Agents; D004338:Drug Combinations; D054714:Echinocandins; D055666:Lipopeptides; D008081:Liposomes; D010456:Peptides, Cyclic; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D000077336:Caspofungin; D065819:Voriconazole