nach oben

Current Infectious Disease Reports

Erschienen in:

01.11.2010

The Role of Second-Generation Antifungal Triazoles for Treatment of the Endemic Mycoses

verfasst von: Alison G. Freifeld, J. Ryan Bariola, David Andes

Erschienen in: Current Infectious Disease Reports | Ausgabe 6/2010

Einloggen, um Zugang zu erhalten

Abstract

Endemic fungi are geographically restricted to certain areas of the United States where they are typically found in soil. They often cause asymptomatic or self-limited flu-like infections in humans. Occasionally, they cause serious human disease including acute or chronic pneumonias, or bone, skin, or central nervous system disease. Amphotericin B and first-generation triazoles are standard therapy for serious endemic fungal infections. Adverse effects, drug intolerance, and rare refractory infections may limit their use; therefore, experience is increasing using newer triazoles (voriconazole and posaconazole) to potentially circumvent these problems. This article reviews the basic scientific information and clinical experience using triazoles for treating endemic fungal infections.

Centers for Disease Control and Prevention, National Center for Zoonotic, Vector-Borne, and Enteric Diseases: A–Z index for foodborne, bacterial, and mycotic diseases. Available at http://www.cdc.gov/nczved/divisions/dfbmd/diseases/index.html. Accessed July 2010.

Wheat LJ, Freifeld AG, Kleiman MB, et al.: Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis 2007, 45:807–825.CrossRefPubMed

Chapman SW, Dismukes WE, Proia LA, et al.: Clinical practice guidelines for the management of blastomycosis: 2008 update by the infectious Diseases Society of America. Clin Infect Dis 2008, 46:1801–1812.CrossRefPubMed

Galgiani JN, Ampel NM, Blair JE, et al.: Coccidioidomycosis. Clin Infect Dis 2005, 41:1217–1223.CrossRefPubMed

Wheat J, MaWhinney S, Hafner R, et al.: Treatment of histoplasmosis with fluconazole in patients with acquired immunodeficiency syndrome. National Institute of Allergy and Infectious Diseases Acquired Immunodeficiency Syndrome Clinical Trials Group and Mycoses Study Group. Am J Med 1997, 103:223–232.CrossRefPubMed

Pappas PG, Bradsher RW, Kauffman CA, et al.: Treatment of blastomycosis with higher doses of fluconazole. The National Institute Of Allergy and Infectious Diseases Mycoses Study Group. Clin Infect Dis 1997, 25:200–205.CrossRefPubMed

• Lestner JM, Roberts SA, Moore CB, et al.: Toxicodynamics of itraconazole: implications for therapeutic drug monitoring. Clin Infect Dis 2009, 49:928–930. This article describes an important study that identifies the upper limit for the itraconazole therapeutic index. CrossRefPubMed

Li RK, Ciblak MA, Nordoff N, et al.: In vitro activities of voriconazole, itraconazole, and amphotericin B against blastomyces dermatitidis, coccidioides immitis, and histoplasma capsulatum. Antimicrob Agents Chemother 2000, 44:1734–1736.CrossRefPubMed

Sabatelli F, Patel R, Mann PA, et al.: In vitro activities of posaconazole, fluconazole, itraconazole, voriconazole, and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob Agents Chemother 2006, 50:2009–2015.CrossRefPubMed

10.

Gonzalez GM, Fothergill AW, Sutton DA, et al.: In vitro activities of new and established triazoles against opportunistic filamentous and dimorphic fungi. Med Mycol 2005, 43:281–284.CrossRefPubMed

11.

Zimmermann T, Yeates RA, Laufen H, et al.: Influence of concomitant food intake on the oral absorption of two triazole antifungal agents, itraconazole and fluconazole. Eur J Clin Pharmacol 1994, 46:147–150.CrossRefPubMed

12.

Dodds Ashley E, Lewis R, Lewis J, et al.: Pharmacology of systemic antifungal agents. Clin Infect Dis 2006, 43:S28–S39.CrossRef

13.

Prentice AG, Glasmacher A: Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother 2005, 56(Suppl 1):i17–i22.CrossRefPubMed

14.

Purkins L, Wood N, Kleinermans D, et al.: Effect of food on the pharmacokinetics of multiple-dose oral voriconazole. Br J Clin Pharmacol 2003, 56(Suppl 1):17–23.CrossRefPubMed

15.

• Krishna G, Moton A, Ma L, et al.: Pharmacokinetics and absorption of posaconazole oral suspension under various gastric conditions in healthy volunteers. Antimicrob Agents Chemother 2009, 53:958–966. The results of this investigation demonstrate the importance of the acidic gastric environment for optimal absorption of posaconazole. CrossRefPubMed

16.

• Dodds Ashley ES, Varkey JB, Krishna G, et al.: Pharmacokinetics of posaconazole administered orally or by nasogastric tube in healthy volunteers. Antimicrob Agents Chemother 2009, 53:2960–2964. The authors describe an important investigation of pharmacokinetics for patients unable to take posaconazole by mouth. CrossRefPubMed

17.

Como JA, Dismukes WE: Oral azole drugs as systemic antifungal therapy. N Engl J Med 1994, 330:263–272.CrossRefPubMed

18.

Poirier JM, Hardy S, Isnard F, et al.: Plasma itraconazole concentrations in patients with neutropenia: advantages of a divided daily dosage regimen. Ther Drug Monit 1997, 19:525–529.CrossRefPubMed

19.

Thiel MA, Zinkernagel AS, Burhenne J, et al.: Voriconazole concentration in human aqueous humor and plasma during topical or combined topical and systemic administration for fungal keratitis. Antimicrob Agents Chemother 2007, 51:239–244.CrossRefPubMed

20.

Lutsar I, Roffey S, Troke P: Voriconazole concentrations in the cerebrospinal fluid and brain tissue of guinea pigs and immunocompromised patients. Clin Infect Dis 2003, 37:728–732.CrossRefPubMed

21.

Willems L, van der Geest R, de Beule K: Itraconazole oral solution and intravenous formulations:a review of pharmacokinetics and pharmacodynamics. J Clin Pharm Ther 2001, 26:159–169.CrossRefPubMed

22.

Perfect JR, Cox GM, Dodge RK, Schell WA: In vitro and in vivo efficacies of the azole SCH56592 against cryptococcus neoformans. Antimicrob Agents Chemother 1996, 40:1910–1913.PubMed

23.

Pitisuttithum P, Negroni R, Graybill JR, et al.: Activity of posaconazole in the treatment of central nervous system fungal infections. J Antimicrob Chemother 2005, 56:745–755.CrossRefPubMed

24.

Muhl E: Antimycotic drugs under continuous renal replacement therapy. Mycoses 2005, 48(Suppl 1):56–60.CrossRefPubMed

25.

Desta Z, Zhao X, Shin JG, Flockhart DA: Clinical significance of the cytochrome P450 2C19 genetic polymorphism. Clin Pharmacokinet 2002, 41:913–958.CrossRefPubMed

26.

Theuretzbacher U, Ihle F, Derendorf H: Pharmacokinetic/pharmacodynamic profile of voriconazole. Clin Pharmacokinet 2006, 45:649–663.CrossRefPubMed

27.

Boyd AE, Modi S, Howard SJ, et al.: Adverse reactions to voriconazole. Clin Infect Dis 2004, 39:1241–1244.CrossRefPubMed

28.

Smith J, Safdar N, Knasinski V, et al.: Voriconazole therapeutic drug monitoring. Antimicrob Agents Chemother 2006, 50:1570–1572.CrossRefPubMed

29.

• Bruggemann RJ, Alffenaar JW, Blijlevens NM, et al.: Clinical relevance of the pharmacokinetic interactions of azole antifungal drugs with other coadministered agents. Clin Infect Dis 2009, 48:1441–1458. This article is a thorough and clinically useful review of triazole drug interactions. CrossRefPubMed

30.

Gearhart MO: Worsening of liver function with fluconazole and review of azole antifungal hepatotoxicity. Ann Pharmacother 1994, 28:1177–1181.PubMed

31.

• Pascual A, Calandra T, Bolay S, et al.: Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. Clin Infect Dis 2008, 46:201–211. This article describes an important clinical study that demonstrates a role for voriconazole therapeutic drug monitoring to optimize efficacy and reduce toxicity. CrossRefPubMed

32.

Girois SB, Chapuis F, Decullier E, Revol BG: Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis. Eur J Clin Microbiol Infect Dis 2005, 24:119–130.CrossRefPubMed

33.

Hoffman HL, Rathbun RC: Review of the safety and efficacy of voriconazole. Expert Opin Investig Drugs 2002, 11:409–429.CrossRefPubMed

34.

Pursley TJ, Blomquist IK, Abraham J, et al.: Fluconazole-induced congenital anomalies in three infants. Clin Infect Dis 1996, 22:336–340.PubMed

35.

Stevens DA, Diaz M, Negroni R, et al.: Safety evaluation of chronic fluconazole therapy. fluconazole pan-American study group. Chemotherapy 1997, 43:371–377.CrossRefPubMed

36.

Ahmad SR, Singer SJ, Leissa BG: Congestive heart failure associated with itraconazole. Lancet 2001, 357:1766–1767.CrossRefPubMed

37.

• Freifeld A, Proia L, Andes D, et al.: Voriconazole use for endemic fungal infections. Antimicrob Agents Chemother 2009, 53:1648–1651. The authors present a case series suggesting the utility of voriconazole for therapy of endemic fungal infections. CrossRefPubMed

38.

• Cuellar-Rodriguez J, Avery RK, Lard M, et al.: Histoplasmosis in solid organ transplant recipients: 10 years of experience at a large transplant center in an endemic area. Clin Infect Dis 2009, 49:710–716. The authors describe a case series highlighting the rarity of histoplasmosis in solid organ transplant recipients, and the generally excellent outcomes with prompt appropriate antifungal therapy. CrossRefPubMed

39.

Wheat LJ, Connolly P, Smedema M, et al.: Activity of newer triazoles against histoplasma capsulatum from patients with AIDS who failed fluconazole. J Antimicrob Chemother 2006, 57:1235–1239.CrossRefPubMed

40.

Connolly P, Wheat LJ, Schnizlein-Bick C, et al.: Comparison of a new triazole, posaconazole, with itraconazole and amphotericin B for treatment of histoplasmosis following pulmonary challenge in immunocompromised mice. Antimicrob Agents Chemother 2000, 44:2604–2608.CrossRefPubMed

41.

Restrepo A, Tobon A, Clark B, et al.: Salvage treatment of histoplasmosis with posaconazole. J Infect 2007, 54:319–327.CrossRefPubMed

42.

Clark B, Foster R, Tunbridge A, Green S: A case of disseminated histoplasmosis successfully treated with the investigational drug posaconazole. J Infect 2005, 51:e177–e180.CrossRefPubMed

43.

Panicker J, Walsh T, Kamani N: Recurrent central nervous system blastomycosis in an immunocompetent child treated successfully with sequential liposomal amphotericin B and voriconazole. Pediatr Infect Dis J 2006, 25:377–379.CrossRefPubMed

44.

Borgia SM, Fuller JD, Sarabia A, El-Helou P: Cerebral blastomycosis: a case series incorporating voriconazole in the treatment regimen. Med Mycol 2006, 44:659–664.CrossRefPubMed

45.

Bakleh M, Aksamit AJ, Tleyjeh IM, Marshall WF: Successful treatment of cerebral blastomycosis with voriconazole. Clin Infect Dis 2005, 40:e69–e71.CrossRefPubMed

46.

• Bariola JR, Perry P, Pappas PG, et al.: Blastomycosis of the central nervous system: a multicenter review of diagnosis and treatment in the modern era. Clin Infect Dis 2010, 50:797–804. The authors present a case series of CNS blastomycosis suggesting that lipid amphotericin B followed by a prolonged course of oral azole, preferably voriconazole, is effective in most cases. CrossRefPubMed

47.

Gauthier GM, Safdar N, Klein BS, Andes DR: Blastomycosis in solid organ transplant recipients. Transpl Infect Dis 2007, 9:310–317.CrossRefPubMed

48.

Anstead GM, Corcoran G, Lewis J, et al.: Refractory coccidioidomycosis treated with posaconazole. Clin Infect Dis 2005, 40:1770–1776.CrossRefPubMed

49.

Stevens DA, Rendon A, Gaona-Flores V, et al.: Posaconazole therapy for chronic refractory coccidioidomycosis. Chest 2007, 132:952–958.CrossRefPubMed

50.

Wollina U, Hansel G, Vennewald I, et al.: Successful treatment of relapsing disseminated coccidioidomycosis with cutaneous involvement with posaconazole. J Dtsch Dermatol Ges 2009, 7:46–49.PubMed

51.

Antony SJ, Jurczyk P, Brumble L: Successful use of combination antifungal therapy in the treatment of coccidioides meningitis. J Natl Med Assoc 2006, 98:940–942.PubMed

52.

Proia LA, Tenorio AR: Successful use of voriconazole for treatment of coccidioides meningitis. Antimicrob Agents Chemother 2004, 48:2341.CrossRefPubMed

53.

• Andes D, Pascual A, Marchetti O: Antifungal therapeutic drug monitoring: established and emerging indications. Antimicrob Agents Chemother 2009, 53:24–34. This article is a useful review of indications for and how to incorporate antifungal therapeutic drug monitoring into clinical practice. CrossRefPubMed

54.

• Smith J, Andes D: Therapeutic drug monitoring of antifungals: pharmacokinetic and pharmacodynamic considerations. Ther Drug Monit 2008, 30:167–172. This article is a review of the data available to discern the utility of antifungal therapeutic drug monitoring. CrossRefPubMed

55.

Tucker RM, Denning DW, Arathoon EG, et al.: Itraconazole therapy for nonmeningeal coccidioidomycosis: clinical and laboratory observations. J Am Acad Dermatol 1990, 23(3 Pt 2):593–601.CrossRefPubMed

56.

Walsh TJ, Raad I, Patterson TF, et al.: Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis 2007, 44:2–12.CrossRefPubMed

57.

• Cowen EW, Nguyen JC, Miller DD, et al.: Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole. J Am Acad Dermatol 2010, 62:31–37. This report highlights the evolving link between chronic photosensitivity during prolonged voriconazole treatment and squamous cell carcinoma of the skin. CrossRefPubMed

58.

• Miller DD, Cowen EW, Nguyen JC, et al.: Melanoma associated with long-term voriconazole therapy: a new manifestation of chronic photosensitivity. Arch Dermatol 2010, 146:300–304. There may also be a link between chronic photosensitivity during prolonged voriconazole treatment and melanoma. CrossRefPubMed

59.

• Vadnerkar A, Nguyen MH, Mitsani D, et al.: Voriconazole exposure and geographic location are independent risk factors for squamous cell carcinoma of the skin among lung transplant recipients. J Heart Lung Transplant 2010. Another case report of chronic voriconazole treatment being linked to photosensitivity-related squamous cell carcinoma of the skin.

Titel: The Role of Second-Generation Antifungal Triazoles for Treatment of the Endemic Mycoses
verfasst von: Alison G. Freifeld
J. Ryan Bariola
David Andes
Publikationsdatum: 01.11.2010
Verlag: Current Science Inc.
Erschienen in: Current Infectious Disease Reports / Ausgabe 6/2010
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI: https://doi.org/10.1007/s11908-010-0133-0

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The Role of Second-Generation Antifungal Triazoles for Treatment of the Endemic Mycoses

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2010

Recent Advances in the Treatment of Mucormycosis

Treatment of Resistant Enterococcal Urinary Tract Infections

Spinal Epidural Abscess: Current Diagnosis and Management

Clinical Spectrum of Desquamative Inflammatory Vaginitis

Invasive Pulmonary Aspergillosis in Patients with Chronic Obstructive Pulmonary Disease: An Emerging Fungal Disease

Management of Urinary Tract Infections Associated with Nephrolithiasis

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin