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Voriconazole

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https://www.readbyqxmd.com/read/28932128/a-suspected-case-of-autoinduction-of-voriconazole-metabolism-in-a-patient-with-cerebral-aspergillosis
#1
Martin J Ferguson, Maria L Randles, Declan G de Freitas
OBJECTIVE: This study aims to report a case of accelerated metabolism of voriconazole in a patient with cerebral aspergillosis. CASE SUMMARY: A 36-year-old woman developed cerebral aspergillosis after immunosuppressive treatment for suspected atypical hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. She was treated with voriconazole using therapeutic drug monitoring to guide dosing. After an initial high level, her dose was reduced, but over the following weeks, she required several dose increases in order to achieve a voriconazole level within the target range...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/28927230/multi-azole-resistant-strains-of-cryptococcus-neoformans-var-grubii-isolated-from-a-flz-resistant-strain-by-culturing-in-medium-containing-voriconazole
#2
Rui Kano, Miki Okubo, Atsuhiko Hasegawa, Hiroshi Kamata
A Cryptococcus neoformans var. grubii strain, NUBS14020, was the first fluconazole (FLZ)-resistant strain isolated from a feline cryptococcosis. Subsequent work demonstrated that multi-azole-resistant strains are readily isolated from FLZ-resistant strains by culturing in medium containing voriconazole (VRZ). The resulting clones were assessed for mutation and expression of known target genes, including the loci encoding lanosterol 14-α demethylase (ERG11), an ATP-binding cassette (ABC) transporter (AFR1), or a multidrug efflux pump (MEP); mutation and/or overexpression of these genes is known to be associated with azole resistance...
September 11, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28926886/-keratectomy-combined-with-intrastromal-injection-of-voriconazole-in-treating-fungal-keratitis
#3
S X Li, J Biang, X Li, L T Zhang, W Y Shi
Objective: To investigate the treatment effect of keratectomy combined with intrastromal injection of voriconazole on fungal keratitis. Methods: Retrospective study. Ninety-eight fungal keratitis patients (98 eyes) were treated by keratectomy combined with intrastromal injection of voriconazole in Shandong Eye Hospital from January 2013 to May 2015. The corneal ulcers were mostly located in the paracentral or peripheral cornea, which incompletely blocked the pupil area. Slit lamp and anterior segment optical coherence tomography (AS-OCT) were used for lesion detection...
September 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28923874/agar-based-screening-for-azole-resistance-in-aspergillus-fumigatus-using-vipcheck%C3%A2-a-single-centre-evaluation
#4
J B Buil, H A L van der Lee, A J M M Rijs, J Zoll, J A M F Hovestadt, W J G Melchers, P E Verweij
Introduction Antifungal susceptibility testing is an essential tool for guiding therapy, although EUCAST and CLSI reference methods are often only available in specialized centres. We studied the performance of an agar-based screening method for the detection of azole resistance in Aspergillus fumigatus cultures.Methods The VIPcheck™ consists of four wells containing voriconazole, itraconazole, posaconazole or a growth control. Ninety-six A. fumigatus isolates were used. Thirty-three isolates harboured a known resistance mechanism: TR34/L98H (11 isolates); TR46/Y121F/T289A (6 isolates); TR53 (2 isolates) and fourteen isolates with other cyp51A-gene point mutations...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28923870/associations-between-voriconazole-therapeutic-drug-monitoring-toxicity-and-outcome-in-liver-transplant-patients-an-observational-study
#5
Zahra Hashemizadeh, Parisa Badiee, Seyed Ali Malekhoseini, Hadi Raeisi Shahraki, Bita Geramizadeh, Hashem Montaseri
The aim of this study was to investigate the variability of voriconazole plasma level and its relationship with clinical outcomes and adverse events, among liver transplant recipients to optimize the efficacy and safety of their treatment. Liver transplant recipients treated with voriconazole were included and voriconazole trough levels were quantified by the validated high-performance liquid chromatography method. Cytochrome P450 genotypes of CYP2C19 were evaluated in allograft liver tissues. A total of 832 voriconazole trough levels from 104 patients were measured...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28923863/synergistic-effects-of-tacrolimus-and-azoles-against-exophiala-dermatitidis
#6
Lujuan Gao, Yi Sun, Chengyan He, Tongxiang Zeng, Ming Li
In vitro interactions of tacrolimus, a calcineurin inhibitor, and azoles including itraconazole, voriconazole, and posaconazole against planktonic cells and biofilms of Exophiala dermatitidis were assessed via broth microdilution checkerboard technique. A total of 16 clinical isolates were studied. The results revealed favorable synergistic inhibitory activity between tacrolimus and itraconazole, voriconazole, or posaconazole against planktonic cells of E. dermatitidis However, limited synergism was observed against biofilms of E...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28920790/pharmacokinetics-efficacy-and-safety-of-voriconazole-and-itraconazole-in-healthy-cottonmouths-agkistrodon-piscivorus-and-massasauga-rattlesnakes-sistrurus-catenatus-with-snake-fungal-disease
#7
Dana M Lindemann, Matthew C Allender, Marta Rzadkowska, Grace Archer, Lauren Kane, Eric Baitchman, Elizabeth A Driskell, Caroline T Chu, Kuldeep Singh, Shih-Hsuan Hsiao, John M Sykes, Sherry Cox
Snake fungal disease (SFD; Ophidiomyces ophiodiicola) is posing a significant threat to several free-ranging populations of pitvipers. Triazole antifungals have been proposed for the treatment of mycoses in reptiles; however, data are lacking about their safety and efficacy in snakes with SFD. Study 1 investigated in vitro susceptibility, and identified that plasma concentrations >250 ng/ml (voriconazole) and >1,000 ng/ml (itraconazole) may be effective in vivo for SFD. In Study 2, the pharmacokinetics after a single subcutaneous voriconazole injection were assessed in apparently healthy free-ranging cottonmouths (Agkistrodon piscivorus)...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28918001/in%C3%A2-vitro-evaluation-of-antimicrobial-agents-on-acanthamoeba-sp-and-evidence-of-a-natural-resilience-to-amphotericin-b
#8
Alexandre Taravaud, Philippe M Loiseau, Sébastien Pomel
The free-living amoeba (FLA) Acanthamoeba sp. is an opportunistic pathogen that can cause amoebic keratitis (AK) or granulomatous amoebic encephalitis (GAE). While current treatments of AK are long with some relapses, no consensus therapy has been developed for GAE remaining lethal in 90% of the cases. In this context, efficient antiacanthamoebal drugs have to be identified. In this work, 15 drugs used in the treatment of AK or GAE or in other parasitic diseases were evaluated for their in vitro activity on A...
September 8, 2017: International Journal for Parasitology, Drugs and Drug Resistance
https://www.readbyqxmd.com/read/28917461/a-cross-sectional-survey-of-voriconazole-prescribers-assessing-current-practice-and-knowledge-of-cutaneous-side-effects
#9
Peter B Chansky, Karolyn Wanat, Lisa Pappas-Taffer, Misha Rosenbach, Robert G Micheletti
No abstract text is available yet for this article.
October 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28902012/comparison-of-oral-voriconazole-versus-oral-ketoconazole-as-an-adjunct-to-topical-natamycin-in-severe-fungal-keratitis-a-randomized-controlled-trial
#10
Namrata Sharma, Deepali Singhal, Prafulla K Maharana, Rajesh Sinha, Tushar Agarwal, Ashish D Upadhyay, Thirumurthy Velpandian, Gita Satpathy, Jeewan S Titiyal
PURPOSE: To compare the efficacy of oral voriconazole (VCZ) with oral ketoconazole (KCZ) as an adjunct to topical natamycin in severe fungal keratitis. METHODS: Fifty eyes of 50 patients with proven severe fungal keratitis, (>5 mm size, involving >4 mm central cornea and >50% stromal depth), smear, and/or culture positive were randomized to receive either oral VCZ (n = 25) or oral KCZ (n = 25) 200 mg twice a day. Both groups received topical natamycin along with oral medication...
September 8, 2017: Cornea
https://www.readbyqxmd.com/read/28901803/in-vitro-activity-of-calcium-channel-blockers-in-combination-with-conventional-antifungal-agents-against-clinically-important-filamentous-fungi
#11
Mónika Homa, Kinga Hegedűs, Ádám Fülöp, Vanessza Wolfárt, Shine Kadaikunnan, Jamal M Khaled, Naiyf S Alharbi, Csaba Vágvölgyi, László Galgóczy
Despite the current therapeutic options, filamentous fungal infections are associated with high mortality rate especially in immunocompromised patients. In order to find a new potential therapeutic approach, the in vitro inhibitory effect of two antiarrhythmic agents, diltiazem and verapamil hydrochloride were tested against different clinical isolates of ascomycetous and mucoralean filamentous fungi. The in vitro combinations of these non-antifungal drugs with azole and polyene antifungal agents were also examined...
September 2017: Acta Biologica Hungarica
https://www.readbyqxmd.com/read/28900769/interface-scopulariopsis-gracilis-fungal-keratitis-following-descemet-s-stripping-automated-endothelial-keratoplasty-dsaek-with-a-contaminated-graft
#12
Craig Wilde, Marco Messina, Tara Moshiri, Susan E Snape, Senthil Maharajan
PURPOSE: To report for the first time a case of interface Scopulariopsis gracilis fungal keratitis following Descemet's stripping automated endothelial keratoplasty (DSAEK) with a contaminated graft. METHODS: A 57-year-old man with bilateral keratoconus and previous bilateral penetrating keratoplasties (PK) developed graft failure in association with marked corneal ectasia. He underwent a successful DSAEK. Unfortunately, a contaminated graft was transplanted and the following morning we were contacted by the eye bank to inform us a slow-growing fungus had been detected in the culture plates inoculated with dextran solution used to store the issued corneoscleral button...
September 12, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28898527/voriconazole-and-squamous-cell-carcinoma-after-lung-transplantation-a-multicenter-study
#13
B Hamandi, C Fegbeutel, F P Silveira, E A Verschuuren, M Younus, J Mo, J Yan, P Ussetti, P V Chin-Hong, A Solé, C L Holmes-Liew, E M Billaud, P A Grossi, O Manuel, D J Levine, R G Barbers, D Hadjiliadis, J Aram, L G Singer, S Husain
This study evaluated the independent contribution of voriconazole to the development of squamous cell carcinoma (SCC) in lung transplant recipients, by attempting to account for important confounding factors, particularly immunosuppression. This international, multicenter, retrospective, cohort study included adult patients who underwent lung transplant during 2005-2008. Cox regression analysis was used to assess the effects of voriconazole and other azoles, analyzed as time-dependent variables, on the risk of developing biopsy-confirmed SCC...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28895710/-trichosporon-asahii-sepsis-associated-with-urinary-catheter-in-a-pediatric-burn-unit-2-case-reports
#14
Florencia Escarrá, Jimena Lema, Beatriz Caracciolo, Susana Carnovale, Verónica Alvarez, Nidia Tramonti, Fabián Guarracino, M Teresa Rosanova
Trichosporon asahii is a ubiquitous fungus that has been isolated as part of human microbiota. There has been an emergence of this pathogen in recent years, causing superficial and deep seated infections. There are scarce reports of urinary tract infections in pediatric intensive care burn units caused by this agent. We describe the cases of 2 pediatric patients with prolonged hospitalization due to severe burns that had received several antibiotic courses for previous infections. Both presented sepsis secondary to catheter related urinary tract infection by Trichosporon asahii...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28893772/triazole-resistance-is-still-not-emerging-in-a-fumigatus-isolates-causing-invasive-aspergillosis-in-brazilian-patients
#15
Clara E Negri, Sarah S Gonçalves, Ana Cristina P Sousa, Maria Daniela Bergamasco, Marinês D V Martino, Flavio Queiroz-Telles, Valerio Rodrigues Aquino, Paulo de Tarso O Castro, Ferry Hagen, Jacques F Meis, Arnaldo L Colombo
Aspergillus fumigatus azole resistance has globally emerged as a health problem. We evaluated the in vitro antifungal susceptibility of 221 clinical A. fumigatus isolates according to CLSI. Sixty-one isolates exhibiting MIC at the epidemiological cut-off value (ECV) for itraconazole or above ECV for any triazole were checked for CYP51A mutations. No mutations were documented, even for four isolates (1.8%) with high voriconazole MICs, indicating that triazoles may be safely used to treat aspergillosis in Brazil...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28893246/voriconazole-and-posaconazole-therapeutic-drug-monitoring-a-retrospective-study
#16
Whitley M Yi, Kelly E Schoeppler, Jaclyn Jaeger, Scott W Mueller, Robert MacLaren, Douglas N Fish, Tyree H Kiser
BACKGROUND: Therapeutic drug monitoring (TDM) aims to minimize the clinical impact of posaconazole and voriconazole pharmacokinetic variability. However, its benefits on clinical outcomes are still being defined. Additionally, TDM data are limited for posaconazole IV and delayed-release tablet formulations among specific patient populations, including critically ill. The aim of this study was to determine the percentage of therapeutic posaconazole and voriconazole drug levels across all formulations in a real-world clinical setting and elucidate factors affecting attainment of target concentrations...
September 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28879155/cylindrocarpon-lichenicola-keratomycosis-in-nigeria-the-challenge-of-limited-access-to-effective-antimicrobials
#17
Emmanuel O Irek, Temitope O Obadare, Patrick A Udonwa, Olajumoke Laoye, Oyekola V Abiri, Adenike O Adeoye, Aaron O Aboderin
INTRODUCTION: We report a rare cause of keratitis, due to Cylindrocarpon lichenicola, in a farmer with keratomycosis. Despite the acknowledged virulence of this fungus, a suitable antifungal for its management was not accessible. CASE PRESENTATION: A 67-year-old farmer presented with a two-week history of pain, mucopurulent discharge, redness and a corneal ulcer with a visual acuity of hand movement in the right eye. With a working diagnosis of infective keratitis, corneal scrapings were taken under a slit lamp biomicroscope for microbiological testing...
2017: African Journal of Laboratory Medicine
https://www.readbyqxmd.com/read/28872724/successful-treatment-of-bilateral-endogenous-fusarium-solani-endophthalmitis-in-a-patient-with-acute-lymphocytic-leukemia
#18
Ilaria Rizzello, Fausto Castagnetti, Pier Giorgio Toschi, Patrizia Bertaccini, Laura Primavera, Michela Paolucci, Luca Faccioli, Luca Spinardi, Russell E Lewis, Michele Cavo, Marta Stanzani
Fusarium spp. are an uncommon cause of fungemia in immunocompromised and neutropenic patients that may hematogenously disseminate to the eyes. Herein, we describe a patient with acute lymphoblastic leukemia and a prior history of extensive corticosteroid exposure who developed disseminated Fusarium solani infection following chemotherapy despite posaconazole prophylaxis. She was successfully treated with combination liposomal amphotericin B and voriconazole, intraocular injections of voriconazole, topical amphotericin B and bilateral vitrectomy...
September 5, 2017: Mycoses
https://www.readbyqxmd.com/read/28870262/virulence-factors-antifungal-susceptibility-and-molecular-mechanisms-of-azole-resistance-among-candida-parapsilosis-complex-isolates-recovered-from-clinical-specimens
#19
Sourour Neji, Ines Hadrich, Houaida Trabelsi, Salma Abbes, Fatma Cheikhrouhou, Hayet Sellami, Fattouma Makni, Ali Ayadi
BACKGROUND: The aim of this study was to determine the biofilm formation, the extracellular enzymatic activities of 182 clinical isolates of the Candida parapsilosis complex. METHODS: Molecular identification of the C. parapsilosis species complex was performed using PCR RFLP of SADH gene and PCR sequencing of ITS region. The susceptibility of ours isolates to antifungal agents and molecular mechanisms underlying azole resistance were evaluated. RESULTS: 63...
September 4, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28869083/antifungal-effect-of-cow-s-urine-distillate-on-candida-species
#20
J M Hoh, B Dhanashree
BACKGROUND: Increase in resistance of Candida species, to routinely used antifungal agents has necessitated the quest for new drugs. Few studies have revealed that cow's urine can suppress the growth of pathogenic fungi. However there is no published report on antifungal effects of cow's urine on clinical Candida isolates. OBJECTIVE: The present study aims at exploring the antifungal potential of cow's urine on clinical isolates of Candida species. MATERIAL & METHODS: In this in-vitro experimental study four standard strains and 37 clinical isolates of Candida species were tested for their susceptibility to amphotericin B, fluconazole and voriconazole, by disk diffusion method...
August 30, 2017: Journal of Ayurveda and Integrative Medicine
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