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Voriconazole

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https://www.readbyqxmd.com/read/28722255/drug-drug-interactions-between-triazole-antifungal-agents-used-to-treat-invasive-aspergillosis-and-immunosuppressants-metabolized-by-cytochrome-p450-3a4
#1
REVIEW
Andreas H Groll, Robert Townsend, Amit Desai, Nkechi Azie, Mark Jones, Marc Engelhardt, Anne-Hortense Schmitt-Hoffman, Robert J Brüggemann
Patients undergoing treatment with immunosuppressant drugs following solid organ or hematopoietic stem cell transplantation are at particular risk for development of serious infections such as invasive aspergillosis. Four triazole antifungal drugs, voriconazole, posaconazole, itraconazole, and isavuconazole, are approved to treat invasive aspergillosis either as first- or second-line therapy. All of these agents are inhibitors of cytochrome P450 3A4, which plays a key role in metabolizing immunosuppressant drugs such as cyclosporine, tacrolimus, and sirolimus...
July 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28721333/pulmonary-cryptococcosis-in-a-ruxolitinib-treated-patient-with-primary-myelofibrosis
#2
Anna Hirano, Masahiro Yamasaki, Naomi Saito, Koji Iwato, Wakako Daido, Kunihiko Funaishi, Sayaka Ishiyama, Naoko Deguchi, Masaya Taniwaki, Nobuyuki Ohashi
We present the case of a 79-year-old man who showed multiple pulmonary nodules on chest computed tomography (CT) after being treated for 6 months with ruxolitinib, an inhibitor of Janus kinase (JAK) 1 and 2, to treat primary myelofibrosis. We examined the lesions by bronchoscopy, and the biopsy specimen revealed fungus bodies of Cryptococcus with granulomatous inflammation. As a result, the patient was diagnosed with pulmonary cryptococcosis. The patient was treated with fluconazole (200 mg daily for 2 weeks) with concomitant ruxolitinib administration, but the pulmonary lesions progressed...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28717040/flucloxacillin-results-in-suboptimal-voriconazole-plasma-concentrations
#3
Eline W Muilwijk, Bart G J Dekkers, Stefanie Henriet, Paul E Verweij, Bregje Witjes, Astrid M L Oude Lashof, Geert H Groeneveld, Johannes van der Hoeven, Jan Willem C Alffenaar, Frans G M Russel, Frank van de Veerdonk, Roger J M Brüggemann
Combining voriconazole and flucloxacillin is indicated in patient cohorts experiencing both invasive aspergillosis and gram-positive infections (e.g. patients with chronic granulomatous disease or post-influenza pulmonary aspergillosis). We report a highly relevant interaction between voriconazole and flucloxacillin resulting in subtherapeutic voriconazole plasma concentrations in more than 50% of patients, posing a severe threat if not managed properly.
July 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28709990/in-vitro-development-of-an-effective-treatment-for-acanthamoeba-keratitis
#4
A Ortillés, J Belloc, E Rubio, M T Fernández, M Benito, J A Cristóbal, B Calvo, P Goñi
The aim of this study was to develop an in-vitro topical treatment for acanthamoeba keratitis (AK) effective against cysts and trophozoites. Qualitative assays were performed with voriconazole, chlorhexidine, propamidine, cellulase, tobramycin, ciprofloxacin and paromomycin as monotherapy and various combinations. Riboflavin with ultraviolet-A (R+UV-A) as monotherapy or combined with voriconazole and moxifloxacin was also tested. Quantitative assays to assess cyst viability after treatment were performed for the chemicals that showed the highest activity in the qualitative assays...
July 11, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28705676/current-antifungal-treatment-of-fusariosis
#5
Abdullah M S Al-Hatmi, Alexandro Bonifaz, Stephane Ranque, G Sybren de Hoog, Paul E Verweij, Jacques F Meis
Fungi of the genus Fusarium are well known as major plant pathogens and soil inhabitants but also cause a broad spectrum of human infections. Fusariosis is the second most common mould infection after aspergillosis and keratitis is the most encountered implantation infection in immunocompetent individuals. Natamycin is active against Fusarium species both in vitro and in vivo, and it is used along with voriconazole as the mainstay of treatment for Fusarium keratitis. Onychomycosis is treated with terbinafine, voriconazole and sometimes itraconazole...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28704121/evaluation-of-in-vitro-antiamoebic-activity-of-antimicrobial-agents-against-clinical-acanthamoeba-isolates
#6
Hidemasa Nakaminami, Kentaro Tanuma, Kiichi Enomoto, Yukihiko Yoshimura, Tomoyo Onuki, Shin Nihonyanagi, Yukihiro Hamada, Norihisa Noguchi
PURPOSE: The aim of this study was to elucidate in vitro antiamoebic activity of antimicrobial agents at short exposure times similar to those used for actual treatment against Acanthamoeba strains isolated from patients with keratitis. METHODS: The 5 clinical Acanthamoeba isolated in Japan were used in this study. Identification of genotypes for the Acanthamoeba isolates was performed using partial 18S ribosomal DNA (rDNA), including the ASA.S1 region sequences...
July 13, 2017: Journal of Ocular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28702763/pharmacokinetics-of-antifungal-drugs-practical-implications-for-optimized-treatment-of-patients
#7
REVIEW
Romuald Bellmann, Piotr Smuszkiewicz
INTRODUCTION: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety. MATERIALS AND METHODS: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy. CONCLUSIONS AND DISCUSSION: Amphotericin B is eliminated unchanged via urine and faeces...
July 12, 2017: Infection
https://www.readbyqxmd.com/read/28699964/antifungal-susceptibility-profile-of-diferent-yeasts-isolates-from-wild-animals-cow-s-milk-with-subclinical-mastitis-and-hospital-environment
#8
J F Mendes, C L Gonçalves, G F Ferreira, I A Esteves, C H Freitas, J P V Villarreal, J R B Mello, M C A Meireles, P S Nascente
Yeast infections have acquired great importance due to increasing frequency in immunocompromised patients or patients undergoing invasive diagnostic and therapeutic techniques, and also because of its high morbidity and mortality. At the same time, it has been seen an increase in the emergence of new pathogenic species difficult to diagnose and treat. The aim of this study was to determine the in vitro susceptibility of 89 yeasts from different sources against the antifungals amphotericin B, voriconazole, fluconazole and flucytosine, using the VITEK® 2 Compact system...
July 10, 2017: Brazilian Journal of Biology, Revista Brasleira de Biologia
https://www.readbyqxmd.com/read/28695649/single-center-experience-of-antifungal-prophylaxis-for-coccidioidomycosis-in-heart-transplant-recipients-within-an-endemic-area
#9
Graham M Lohrmann, Darko Vucicevic, Romy Lawrence, D Eric Steidley, Robert L Scott, Shimon Kusne, Janis E Blair
In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28694233/comparing-the-safety-and-efficacy-of-voriconazole-versus-posaconazole-in-the-prevention-of-invasive-fungal-infections-in-high-risk-patients-with-hematological-malignancies
#10
Ray Hachem, Andrew Assaf, Yazan Numan, Pankil Shah, Ying Jiang, Anne-Marie Chaftari, Issam I Raad
Invasive fungal infection (IFI) is a leading cause of morbidity and mortality in immunocompromised cancer patients. New triazole-based antifungal agents have been recommended for IFI prophylaxis in these patients. This retrospective study compared the safety and efficacy of voriconazole and posaconazole as prophylaxis in patients with hematological malignancies (HM), who were admitted to The University of Texas MD Anderson Cancer Center between January 2014 and August 2015, and who were started on single antifungal prophylaxis consisting of either voriconazole or posaconazole...
July 7, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28685218/influence-of-cyp2c19-genotypes-on-the-occurrence-of-adverse-drug-reactions-of-voriconazole-among-hematological-patients-after-allo-hsct
#11
Beata Sienkiewicz, Donata Urbaniak-Kujda, Jarosław Dybko, Andrzej Dryś, Magdalena Hurkacz, Tomasz Wróbel, Anna Wiela-Hojeńska
The aim of this study was to determine the influence of different CYP2C19 genotypes on selected liver function parameters, and ADR occurrence during VCZ prophylaxis in adult patients after allo-HSCT (allogeneic hematopoietic stem cell transplantation). CYP2C19 mutations were determined in a cohort of 30 adults using PCR-RFLP methods established by Sim et al. and Goldstein and Blaisdell. The patients' protocol included biometrical and biochemical data, information on the underlying disease, chemotherapy, molds infections occurring during VCZ treatment, adverse drug reactions typical for the use of voriconazole, and probable drug - drug interactions...
July 6, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28674358/acute-kidney-injury-from-excessive-potentiation-of-calcium-channel-blocker-via-synergistic-cyp3a4-inhibition-by-clarithromycin-plus-voriconazole
#12
Eikan Mishima, Kazuichi Maruyama, Toru Nakazawa, Takaaki Abe, Sadayoshi Ito
CYP3A4-inhibitors can potentiate the hypotensive effect of calcium-channel blockers. However, insufficient attention to such drug interactions may result in serious adverse reactions. A 71-year-old hypertensive man prescribed nifedipine was hospitalized for infectious endophthalmitis. Antimicrobial therapy with voriconazole lowered the blood pressure, and then clarithromycin further lowered it through the excessively elevated nifedipine concentration, leading to ischemic acute kidney injury. After the discontinuation of clarithromycin and voriconazole, the blood pressure and renal function were recovered...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28672965/endobronchial-aspergilloma-a-case-report-and-literature-review
#13
Dongdong Huang, Bing Li, Haiqing Chu, Zhemin Zhang, Qiuhong Sun, Lan Zhao, Liyun Xu, Li Shen, Tao Gui, Huikang Xie, Jun Zhang
The present study aimed to investigate the clinical and radiological characteristics in addition to the bronchoscopic appearance in patients with endobronchial aspergilloma (EBA). Clinical and radiological characteristics were analyzed alongside the bronchoscopic appearance in 17 patients with EBA diagnosed by bronchoscopy with histological examination. The present study assessed the relevant literature and 13 males and 4 females were included in the comparison, with a median age of 59. Associated diseases included 8 previous diagnoses of pulmonary tuberculosis (47...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28671171/early-onset-de-novo-invasive-pulmonary-aspergillosis-in-an-orthotopic-heart-transplant-recipient
#14
Zaw Min, Manik Veer, Parth Rali, Anil Singh, Nitin Bhanot
Invasive aspergillosis generally occurs during the first 1-6 months after heart transplantation. It has been rarely seen in the first 2 weeks postcardiac transplant. We herein describe a unique case of invasive pulmonary aspergillosis (IPA) diagnosed on day 9 postorthotopic heart transplantation. The known risk factors for IPA in cardiac transplant recipients were not identified in our case. The organ recipients from the same donor did not report Aspergillus infection. Hospital environmental samplings failed to demonstrate Aspergillus spores in the patient's room and his adjacent rooms...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28669678/virulence-and-antifungal-therapy-of-murine-disseminated-infection-by-rhodotorula-mucilaginosa
#15
Pamela Thomson, Loida López-Fernández, Josep Guarro, Javier Capilla
Rhodotorula infections have emerged in recent years causing mainly fungemia associated to high mortality. We have evaluated the in vitro activity of nine antifungal drugs against four clinical strains of Rhodotorula mucilaginosa, being amphotericin B, voriconazole and posaconazole the most active compounds. The experimental virulence of this fungus and the efficacy of the three mentioned drugs were evaluated in disseminated infections in neutropenic mice. Infection resulted in a high fungal load in all the organs studied without evident particular tropism...
June 16, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28665443/management-of-presumed-endogenous-fungal-endophthalmitis-in-a-child-with-acute-lymphoblastic-leukemia
#16
Katherine E Uyhazi, Anton M Kolomeyer, Iga N Gray, Anastasia Traband, Anita A Kohli, Joan M O'Brien, Albert M Maguire
The authors describe a case of presumed endogenous fungal endophthalmitis in an immunocompetent pediatric patient with acute lymphoblastic leukemia. A 15-year-old boy with a history of high-risk B-cell acute lymphoblastic leukemia status post-chemotherapy presented with acute changes in vision in his left eye. Fundus examination revealed a white bi-lobed chorioretinal lesion with overlying vitritis and associated subretinal fluid. Magnetic resonance imaging of the brain revealed small ring-enhancing lesions in the right parietal and left occipital lobes...
June 29, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28661568/everolimus-induced-nephrotic-syndrome-precipitated-by-interaction-with-voriconazole-in-a-patient-with-hodgkin-s-lymphoma
#17
P N Tran, L C Pinter-Brown
WHAT IS KNOWN AND OBJECTIVES: Everolimus is a small molecule that inhibits the mammalian target of rapamycin (mTOR) and is used for treatment of various solid tumours and renal transplant rejection prophylaxis. Whereas everolimus-induced proteinuria was previously observed in 3%-36% renal transplant recipients, nephrotic syndrome was not reported in cancer patients taking everolimus. However, nephrotic syndrome was reported in patients taking sirolimus. CASE SUMMARY: We report the case of a 32-year-old female with relapsed Hodgkin's lymphoma who was on everolimus for 5 years and developed nephrotic syndrome about 2 months after initiation of voriconazole...
June 29, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28660636/pulmonary-co-infections-by-pneumocystis-jirovecii-and-aspergillus-fumigatus-in-non-hiv-patients-a-report-of-two-cases-and-literature-review
#18
REVIEW
Anthi-Marina Markantonatou, Aliki Ioakimidou, Kostoula Arvaniti, Eleni Manou, Vassilios Papadopoulos, Parthena Kiriklidou, Konstantinos Samaras, Anna Kioumi, Timoleon-Achilleas Vyzantiadis
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PcP), a common and often life-threatening opportunistic infection in HIV-infected patients. However, non-HIV, immunocompromised patients are at risk of PcP as well, whereas the mortality appears to be higher among these patients. Pneumocystis co-infections with other microorganisms are less frequent and only sparse reports of combined PcP and invasive pulmonary fungal infections exist in the literature, especially in the non-HIV patients...
June 28, 2017: Mycoses
https://www.readbyqxmd.com/read/28660464/respiratory-tract-infection-caused-by-fonsecaea-monophora-after-kidney-transplantation
#19
Isabella Barbosa Cleinman, Sarah Santos Gonçalves, Marcio Nucci, Danielle Carvalho Quintella, Márcia Halpern, Tiyomi Akiti, Glória Barreiros, Arnaldo Lopes Colombo, Guilherme Santoro-Lopes
Fonsecaea spp. are melanized fungi which cause most cases of chromoblastomycosis. The taxonomy of this genus has been revised, now encompassing four species, with different pathogenic potential: F. pedrosoi, F. nubica, F. pugnacius, and F. monophora. The latter two species present wider clinical spectrum and have been associated with cases of visceral infection, most often affecting the brain. To our knowledge, this is the first report of proven case of F. monophora respiratory tract infection. A Brazilian 57-year-old-female patient underwent kidney transplantation on January 12, 2013...
June 28, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28657120/genetic-diversity-and-antifungal-susceptibility-of-fusarium-isolates-in-onychomycosis
#20
Priscila D Rosa, Daiane Heidrich, Carolina Corrêa, Maria Lúcia Scroferneker, Gerson Vettorato, Alexandre M Fuentefria, Luciano Z Goldani
Fusarium species have emerged as an important human pathogen in skin disease, onychomycosis, keratitis and invasive disease. Onychomycosis caused by Fusarium spp. The infection has been increasingly described in the immunocompetent and immunosuppressed hosts. Considering onychomycosis is a difficult to treat infection, and little is known about the genetic variability and susceptibility pattern of Fusarium spp., further studies are necessary to understand the pathogenesis and better to define the appropriate antifungal treatment for this infection...
June 28, 2017: Mycoses
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