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Posaconazole

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https://www.readbyqxmd.com/read/28533238/posaconazole-induced-hypertension-and-hypokalemia-in-vivo-11%C3%AE-hydroxysteroid-dehydrogenase-inhibition
#1
George R Thompson, Diana Chang, Rebecca R Wittenberg, Ian McHardy, Alison Semrad
We describe a case of apparent mineralocorticoid excess (AME) secondary to posaconazole and suggest the biochemical mechanism. Clinical and laboratory investigation confirmed 11β-hydroxysteroid dehydrogenase inhibition and withholding therapy led to a resolution of all clinical and laboratory abnormalities. A lower dose of posaconazole was later restarted and avoided recurrence of this syndrome. Additional studies are necessary to determine the frequency of posaconazole induced AME and whether other azole antifungals can be associated with this phenomenon...
May 22, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28527169/isolated-renal-mucormycosis
#2
R Sriranga, Satyajeet Pawar, Wasim Khot, Neeraj Nischal, Manish Soneja, H A Venkatesh, Ragesh R Nair, Raj Kanna, Mehar C Sharma, S K Sharma
Mucormycosis in humans has been described as early as 1885 in literature. Isolated renal mucormycosis is rare as it has been mainly described in developing countries like India and China. It is rarer still to find this entity in immunocompetent young males without any risk factors. Specific guidelines on the treatment is not yet known but combined surgical and medical therapy is considered the best modality for its management. We describe a young male who presented with bilateral hydroureteronephrosis. He was initially treated as a case renal tuberculosis which is relatively more common in TB endemic country like ours...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28526521/coexistence-of-aspergilloma-and-pulmonary-hydatid-cyst-in-an-immunocompetent-individual
#3
F Aala, H Badali, S Hashemi Fesharaki, M Boroumand, M Sotoudeh Anvari, H Davari, S Agha Kuchak Afshari, S Khodavaisy
Echinococcosis is a zoonotic disease caused by Echinococcus granulosus sensu lato. The liver and lungs are the most commonly sites of infections, but involvements of other organs were also observed. Recently, the coinfection of pulmonary hydatid cyst with aspergilloma has been reported in the literature. Herein, we report a successful treatment of coinfection of cystic echinoccosis with aspergilloma due to Aspergillus flavus in a 34-year-old female. In vitro antifungal susceptibility tests revealed that the MIC values for antifungals employed in this case were posaconazole (0...
May 16, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28513812/common-dermatophytes-and-in-vitro-anti-fungal-susceptibility-testing-in-patients-attending-the-dermatological-clinic-at-the-hospital-for-tropical-medicine-bangkok
#4
Watcharamat Muangkaew, Thanwa Wongsuk, Natthanej Luplertlop
Dermatophytes comprising the genera Trichophyton, Microsporum, and Epidermophyton are important causes of superficial mycoses. The number of infected patients and the distribution of species of these organisms in our hospital were unknown. We therefore aimed to investigate the clinical pattern of dermatophyte infections and to identify the species of these dermatophytes at the Dermatological Clinic of the Hospital for Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok in a 1-year period...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28508692/seifem-2010-e-economic-evaluation-of-posaconazole-for-antifungal-prophylaxis-in-patients-with-acute-myeloid-leukemia-receiving-induction-chemotherapy
#5
Alessandro Busca, Federica Lessi, Luisa Verga, Anna Candoni, Chiara Cattaneo, Simone Cesaro, Giulia Dragonetti, Mario Delia, Alessio De Luca, Gaspare Guglielmi, Mario Tumbarello, Giordana Martino, Gianpaolo Nadali, Rosa Fanci, Marco Picardi, Leonardo Potenza, Annamaria Nosari, Franco Aversa, Livio Pagano
Posaconazole demonstrated clinical superiority over fluconazole and itraconazole for prophylaxis of mold infections, although concerns exist regarding the high acquisition cost for posaconazole. In this respect, we sought to analyze the costs of antifungal prophylaxis in patients with acute myeloid leukemia (AML) who received prophylactic posaconazole (n = 510, 58%), itraconazole (n = 120, 14%) or fluconazole (n = 175, 20%) during induction chemotherapy. The estimated cost of antifungal prophylaxis as well as the costs of subsequent systemic antifungal therapy for treatening an invasive fungal infections (IFI) was higher in the posaconazole group compared to itraconazole and fluconazole groups...
May 16, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28507111/real-life-assessment-of-the-safety-and-effectiveness-of-the-new-tablet-and-intravenous-formulations-of-posaconazole-in-the-prophylaxis-of-invasive-fungal-infections-analysis-of-343-courses
#6
Frank P Tverdek, Sang Taek Heo, Samuel L Aitken, Bruno Granwehr, Dimitrios P Kontoyiannis
BACKGROUND: Posaconazole is the preferred mold-active azole for prophylaxis against invasive fungal infection (IFI) in patients with hematologic malignancy (HM). Delayed release tablet and intravenous formulations of posaconazole have recently become available, but clinical data are limited. We sought to examine the real-world pharmacokinetics and prophylactic effectiveness of the new formulations of posaconazole given as prophylaxis in patients with HM. METHODS: A retrospective cohort of all consecutive adult inpatients with HM who received ≥3 days of posaconazole as tablet or intravenous from 12/1/2013-12/31/2015 for primary IFI prophylaxis at MD Anderson Cancer center...
May 15, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28507109/erg11-gene-mutations-and-mdr1-up-regulation-confer-pan-azole-resistance-in-candida-tropicalis-causing-disseminated-candidiasis-while-on-posaconazole-prophylaxis-in-an-acute-lymphoblastic-leukemia-patient
#7
Liangshun You, Wenbin Qian, Qing Yang, Liping Mao, Li Zhu, Xianbo Huang, Jie Jin, Haitao Meng
In this study, we presented a rare case of fatal breakthrough Candida tropicalis in a patient with acute lymphoblastic leukemia (ALL) while on posaconazole prophylaxis. And then we explored the mechanisms underlying azole resistance by focusing on enhanced efflux pumps and changes in the azole target enzyme Erg11p, which was encoded by the ERG11 gene. Our study demonstrates that Y132C substitution of Erg11p combined with MDR1 overexpression may be the pan-azole-resistance mechanisms in Candida tropicalis.
May 15, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28504318/antifungal-prophylaxis-in-newly-diagnosed-aml-patients-adherence-to-guidelines-and-feasibility-in-a-real-life-setting
#8
Sophie Berking, Daphne Doedens, Heidi Horns, Michael Fiegl, Helmut Ostermann, Christina T Rieger
Antifungal posaconazole prophylaxis for AML patients receiving induction chemotherapy has been routine at our centre since 2009. This retrospective study examined the feasibility and practicability of our prophylaxis guidelines in clinical practice. Data sets of 90 patients undergoing induction-chemotherapy for AML between 2011 and 2014 were evaluated regarding adherence to local guidelines for the administration of antifungal prophylaxis with posaconazole. 75.5% of the 90 patients received posaconazole prophylaxis...
May 15, 2017: Mycoses
https://www.readbyqxmd.com/read/28497121/implementation-of-isavuconazole-in-a-fluorescence-based-high-performance-liquid-chromatography-kit-allowing-simultaneous-detection-of-all-four-currently-licensed-mold-active-triazoles
#9
René Jørgensen, Siri Rytcher Andersen, Karen Marie Thyssen Astvad, Maiken Cavling Arendrup
Isavuconazole (ISZ) is a newly available broad-spectrum triazole agent recently approved for the treatment of both invasive aspergillosis and mucormycosis. The aim of this study was to develop a simple and reliable method for therapeutic drug monitoring (TDM) of ISZ in human plasma samples. The method involves using a kit from ChromSystems intended for TDM of itraconazole (ITZ), posaconazole (PSZ), and voriconazole (VRZ) in serum/plasma for sample preparation and high-performance liquid chromatography, using fluorescence detection with emission and excitation wavelengths set to 261 and 366 nm, respectively...
May 2017: MSphere
https://www.readbyqxmd.com/read/28493006/activity-of-combined-antifungal-agents-against-multidrug-resistant-candida-glabrata-strains
#10
Laura Bedin Denardi, Jéssica Tairine Keller, Vanessa Oliveira, Débora Alves Nunes Mario, Janio Morais Santurio, Sydney Hartz Alves
In this study, we evaluated the in vitro activity of echinocandins, azoles, and amphotericin B alone and in combination against echinocandin/azole-sensitive and echinocandin/azole-resistant Candida glabrata isolates. Susceptibility tests were performed using the broth microdilution method in accordance with the Clinical and Laboratory Standards Institute document M27-A3. The checkerboard method was used to evaluate the fractional inhibitory concentration index of the interactions. Cross-resistance was observed among echinocandins; 15% of the isolates resistant to caspofungin were also resistant to anidulafungin and micafungin...
May 10, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28485470/treatment-of-refractory-sino-nasal-aspergillosis-with-posaconazole-and-terbinafine-in-10-dogs
#11
J Stewart, D Bianco
OBJECTIVES: To determine the safety and efficacy of posaconazole and terbinafine for the treatment of naturally occurring sino-nasal aspergillosis in dogs refractory to conventional topical and systemic treatment. MATERIALS AND METHODS: Ten client-owned dogs with sino-nasal aspergillosis and not responsive to conventional treatments were prospectively enrolled to receive a dose of 5 mg/kg posaconazole orally every 12 hours for six months. All dogs were concurrently treated with doses of 30 mg/kg terbinafine orally every 12 hours and 5 mg/kg doxycycline orally every 12 hours for 6 to 18 months...
May 9, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28483449/luliconazole-an-alternative-antifungal-agent-against-aspergillus-terreus
#12
M Zargaran, S Taghipour, N Kiasat, E Aboualigalehdari, A Rezaei-Matehkolaei, A Zarei Mahmoudabadi, F Shamsizadeh
Aspergillus terreus is the fourth leading cause of invasive and non-invasive aspergillosis and one of the causative agents of morbidity and mortality among immunocompromised and high-risk patients. A. terreus appears to have increased as a cause of opportunistic fungal infections from superficial to serious invasive infections. Although, invasive aspergillosis is often treated empirically with amphotericin B, most A. terreus isolates are resistant both in vivo and in vitro to some antifungal drugs. In this study, we aimed to evaluate antifungals susceptibility profiles of the different strains of A...
May 5, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28475803/multicentre-study-of-posaconazole-delayed-release-tablet-serum-level-and-association-with-hepatotoxicity-and-qtc-prolongation
#13
Natasha N Pettit, Marisa H Miceli, Christina G Rivera, Prasanna P Narayanan, Anthony J Perissinotti, Meier Hsu, Jennifer Delacruz, Zivile Gedrimaite, Zhe Han, Jennifer Steinbeck, Jennifer Pisano, Susan K Seo, Alla Paskovaty
Objectives: The association of posaconazole serum concentrations and toxicity is unclear. An assessment of whether levels obtained with the delayed-release tablet (DRT) formulation are correlated with abnormal liver function test (LFT) results and/or QTc prolongation was undertaken. Methods: This was a multicentre, retrospective, observational study of adult patients with cancer between 26 November 2013 and 14 November 2014. Patients were included if they received posaconazole DRT with a posaconazole level obtained between days 5 and 14...
May 5, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28461309/crystal-structure-of-the-new-investigational-drug-candidate-vt-1598-in-complex-with-aspergillus-fumigatus-sterol-14%C3%AE-demethylase-provides-insights-into-its-broad-spectrum-antifungal-activity
#14
Tatiana Y Hargrove, Edward P Garvey, William J Hoekstra, Christopher M Yates, Zdzislaw Wawrzak, Girish Rachakonda, Fernando Villalta, Galina I Lepesheva
Within the past decades, the incidence and complexity of human fungal infections have increased, and therefore the need for safer and more efficient, broad-spectrum antifungal agents is high. Herein, we characterize the new tetrazole-based drug candidate VT-1598 as an inhibitor of sterol 14α-demethylase (CYP51B) from the filamentous fungi Aspergillus fumigatus VT-1598 displayed a high binding affinity to the enzyme in solution (with the Kd of 13±1 nM) and in the reconstituted enzymatic reaction revealed the inhibitory potency stronger than the potencies of all other simultaneously tested antifungal drugs, including fluconazole, voriconazole, ketoconazole, and posaconazole...
May 1, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28458993/chromoblastomycosis-caused-by-rhinocladiella-similis-case-report
#15
Daiane Heidrich, Gloria M González, Danielle M Pagani, Mauricio Ramírez-Castrillón, Maria Lucia Scroferneker
We report a case of chromoblastomycosis in lesions on the chest and foot. Itraconazole was chosen as the initial treatment for this patient, who was followed up for 8 months before becoming noncompliant. The pathogenic fungal species was identified as Rhinocladiella similis by ITS region sequencing. In vitro analyses indicate that the fungus was sensitive to posaconazole and itraconazole. This report presents R. similis as a new agent of chromoblastomycosis and raises the hypothesis that this species could be more resistant to some antifungals than R...
June 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28456868/comparative-pathogenicity-of-lomentospora-prolificans-scedosporium-prolificans-isolates-from-mexican-patients
#16
Mariana Elizondo-Zertuche, Alexandra M Montoya, Efrén Robledo-Leal, Idalia Garza-Veloz, Ana L Sánchez-Núñez, Raquel Ballesteros-Elizondo, Gloria M González
We identified 11 Lomentospora prolificans isolates recovered from Mexican patients using phenotypic and molecular characteristics. The identification of isolates was assessed by internal transcribed spacer (ITS rDNA) sequencing. In vitro susceptibility to amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin, anidulafungin and micafungin was determined according to Clinical and Laboratory Standards Institute (CLSI) procedures. Three isolates (07-2239, 11-2242 and 04-2673) were used to induce systemic infection in immunocompetent ICR mice...
April 29, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28455999/pharmacokinetics-of-posaconazole-in-koalas-phascolarctos-cinereus-after-intravenous-and-oral-administration
#17
S Gharibi, B Kimble, L Vogelnest, J Barnes, C K Stadler, M Govendir
The pharmacokinetic profile of posaconazole in clinically normal koalas (n = 8) was investigated. Single doses of posaconazole were administered intravenously (i.v.; 3 mg/kg; n = 2) or orally (p.o.; 6 mg/kg; n = 6) with serial plasma samples collected over 24 and 36 hr, respectively. Plasma concentrations of posaconazole were quantified by validated high-performance liquid chromatography. A noncompartmental pharmacokinetic analysis of data was performed. Following i.v. administration, estimates of the median (range) of plasma clearance (CL) and steady-state volume of distribution (Vss ) were 0...
April 29, 2017: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28451560/caspofungin-non-susceptible-candida-orthopsilosis-isolated-from-onychomycosis-in-iran
#18
Rasoul Mohammadi, Hossein Mirhendi, Mohammad Taghi Hedayati, Hamid Badali
BACKGROUND: Although Candida albicans remains the most common fungal isolate from clinical specimens, many studies have detected a shift towards non-albicans Candida species. Despite worrying clinical pictures associated with latter species, there is little information regarding its susceptibility patterns against currently available antifungal agents, with only a small number of strains having been studied. METHODS: We evaluated the in vitro antifungal susceptibilities of clinical isolates of C...
February 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28446325/-current-status-and-future-perspectives-of-primary-antifungal-prophylaxis-in-patients-with-hematological-malignancies-review
#19
Yan Li, Li Yu
Invasive fungal diseases (IFD) are associated with considerable morbidity and mortality in patients with hematological malignancies. Primary antifungal prophylaxis (PAP) is effective for decreasing incidence of IFD, and the patients will be more tolerable to chemotherapy with less cost and better prognosis. Antifungal drugs as fluconazole, itraconazole, posaconazole, caspofungin and micafungin are all recommended for PAP by many consensus and guidelines. The PAP will be more scientific, appropriate and effective with the development of studies about predicting risk-stratification for IFD, new drugs, pharmacokinetics and integrated prophylaxis...
April 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28443986/minimal-inhibitory-concentration-distributions-and-epidemiological-cutoff-values-of-five-antifungal-agents-against-sporothrix-brasiliensis
#20
Rodrigo Almeida-Paes, Fábio Brito-Santos, Maria Helena Galdino Figueiredo-Carvalho, Ana Caroline Sá Machado, Manoel Marques Evangelista Oliveira, Sandro Antonio Pereira, Maria Clara Gutierrez-Galhardo, Rosely Maria Zancopé-Oliveira
BACKGROUND: Sporothrix brasiliensis is the most virulent sporotrichosis agent. This species usually responds to antifungal drugs, but therapeutic failure can occur in some patients. Antifungal susceptibility tests have been performed on this species, but no clinical breakpoints (CBPs) are available. In this situation, minimal inhibitory concentration (MIC) distributions and epidemiological cutoff values (ECVs) support the detection of identification of resistant strains. OBJECTIVES: To study the MIC distributions of five antifungal drugs against S...
May 2017: Memórias do Instituto Oswaldo Cruz
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