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Current Fungal Infection Reports

Erschienen in:

26.03.2020 | Pharmacology and Pharmacodynamics of Antifungal Agents (J Amsden, Section Editor)

Azole-Resistant Aspergillus and Echinocandin-Resistant Candida: What Are the Treatment Options?

verfasst von: Alison R. Novak, Mary E. Bradley, Tyree H. Kiser, Scott W. Mueller

Erschienen in: Current Fungal Infection Reports | Ausgabe 2/2020

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Abstract

Purpose of Review

This review summarizes current treatment options for echinocandin-resistant Candida spp. (ERC) and azole-resistant Aspergillus fumigatus (ARAF), emphasizing recent in vitro/in vivo data, clinical reports, and consensus statements.

Recent Findings

Advances in ERC and ARAF treatment are limited to specific antifungal combinations and dose optimization but remain reliant on amphotericin products. Although novel antifungals may provide breakthroughs in the treatment of resistant fungi, these agents are not yet available. Early identification and appropriate treatment remain a paramount, albeit elusive, task.

Summary

When either ERC or ARAF are suspected or proven, amphotericin products remain the cornerstone of initial therapy. For ERC, azoles are de-escalation options for susceptible isolates in stable patients to avoid amphotericin toxicities. Although combination echinocandin with high-dose salvage posaconazole or isavuconazole may be attempted in ARAF, it requires careful consideration following patient stabilization. Future research defining optimal therapies and early identification of ERC and ARAF is of extreme importance.

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Titel: Azole-Resistant Aspergillus and Echinocandin-Resistant Candida: What Are the Treatment Options?
verfasst von: Alison R. Novak
Mary E. Bradley
Tyree H. Kiser
Scott W. Mueller
Publikationsdatum: 26.03.2020
Verlag: Springer US
Erschienen in: Current Fungal Infection Reports / Ausgabe 2/2020
Print ISSN: 1936-3761
Elektronische ISSN: 1936-377X
DOI: https://doi.org/10.1007/s12281-020-00379-2

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Invasive Fungal Infections of the Central Nervous System in Immune-Competent Hosts

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Azole-Resistant Aspergillus and Echinocandin-Resistant Candida: What Are the Treatment Options?

Abstract

Purpose of Review

Recent Findings

Summary

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