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antifungal combination therapy

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https://www.readbyqxmd.com/read/28802855/antifungal-resistance-in-mucorales
#1
E Dannaoui
The order Mucorales, which includes the agents of mucormycosis, comprises a large number of species. These fungi are characterized by high-level resistance to most currently available antifungal drugs. Standardized antifungal susceptibility testing methods are now available, allowing a better understanding of the in vitro activity of antifungal drugs against members of Mucorales. Such tests have made apparent that antifungal susceptibility within this group may be species-specific. Experimental animal models of mucormycosis have also been developed and are of great importance in bridging the gap between in vitro results and clinical trials...
August 9, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28797882/repurposing-antipsychotic-drugs-into-antifungal-agents-synergistic-combinations-of-azoles-and-bromperidol-derivatives-in-the-treatment-of-various-fungal-infections
#2
Selina Y L Holbrook, Atefeh Garzan, Emily K Dennis, Sanjib K Shrestha, Sylvie Garneau-Tsodikova
As the number of hospitalized and immunocompromised patients continues to rise, invasive fungal infections, such as invasive candidiasis and aspergillosis, threaten the life of millions of patients every year. The azole antifungals are currently the most prescribed drugs clinically that display broad-spectrum antifungal activity and excellent oral bioavailability. Yet, the azole antifungals have their own limitations and are unable to meet the challenges associated with increasing fungal infections and the accompanied development of resistance against azoles...
July 19, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28782144/syndrome-of-inappropriate-antidiuretic-hormone-secretion-from-concomitant-use-of-itraconazole-and-vindesine
#3
H Zhou, L Li, Y Zhou, Y Han
WHAT IS KNOWN AND OBJECTIVE: Several studies have reported that itraconazole-induced inhibition of vincristine (VCR) metabolism might result in neurological impairment and syndrome of inappropriate antidiuretic hormone (SIADH). However, there are few reports concerning adverse drug reactions (ADRs) resulting from concomitant use of vindesine (VDS) and itraconazole. Here, we report the first case of adverse drug interactions (ADIs) between itraconazole and VDS in a Chinese child with acute lymphocytic leukaemia (ALL)...
August 6, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28771470/chromoblastomycosis-in-india-review-of-169-cases
#4
REVIEW
Reshu Agarwal, Gagandeep Singh, Arnab Ghosh, Kaushal Kumar Verma, Mragnayani Pandey, Immaculata Xess
Chromoblastomycosis (CBM) is a chronic, progressive, cutaneous and subcutaneous fungal infection following the traumatic implantation of certain dematiaceous fungi. The disease has worldwide prevalence with predominant cases reported from humid tropical and subtropical regions of America, Asia, and Africa. Diagnosis is often delayed or misdirected either due to poor degree of clinical suspicions or clinical simulation of dermatological conditions. The infection is not uncommon in India and several case reports from the sub-Himalayan belt and western and eastern coasts of India have been published; however, very few have reviewed the cases...
August 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28766033/antifungal-mechanism-of-the-combination-of-cinnamomum-verum-and-pelargonium-graveolens-essential-oils-with-fluconazole-against-pathogenic-candida-strains
#5
Rym Essid, Majdi Hammami, Dorra Gharbi, Ines Karkouch, Thouraya Ben Hamouda, Salem Elkahoui, Ferid Limam, Olfa Tabbene
The present study aimed to investigate the anti-Candida activity of ten essential oils (EOs) and to evaluate their potential synergism with conventional drugs. The effect on secreted aspartic protease (SAP) activity and the mechanism of action were also explored. The antifungal properties of essential oils were investigated using standard micro-broth dilution assay. Only Cinnamomum verum, Thymus capitatus, Syzygium aromaticum, and Pelargonium graveolens exhibited a broad spectrum of activity against a variety of pathogenic Candida strains...
August 1, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28762125/progress-in-definition-prevention-and-treatment-of-fungal-infections-in-cystic-fibrosis
#6
REVIEW
Carsten Schwarz, Dominik Hartl, Olaf Eickmeier, Andreas Hector, Christian Benden, Isabelle Durieu, Amparo Sole, Silvia Gartner, Carlos E Milla, Peter James Barry
Cystic fibrosis (CF) is a chronic lethal multi-system condition; however, most of the morbidity and mortality is dependent on the status of the respiratory system. Progressive respiratory decline is mediated by chronic infection and inflammation, punctuated by important acute events known as pulmonary exacerbations which can lead to accelerated decline. The main bacterial species causing infections include Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae and Achromobacter xylosoxidans. In addition to bacteria, fungi are detected in a significant number of patients...
July 31, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28739646/koh-mount-as-an-aid-in-the-management-of-infectious-keratitis-at-secondary-eye-care-centre
#7
Varsha M Rathi, Monica Thakur, Savitri Sharma, Rohit Khanna, Prashant Garg
AIMS: To report the clinical outcome of infectious keratitis managed after doing 10% KOH mount of corneal smears and reporting done by an ophthalmologist in the secondary eye care centre in South India. METHODS: 103 consecutive cases of microbial keratitis were studied. Inclusion criteria were presence of corneal infiltrate on slit lamp biomicroscopy. An ophthalmologist carried out microbiological evaluation of 10% KOH mount of corneal scrapings. No cultures were done at secondary centres...
July 24, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28724328/smart-tetrazole-based-antibacterial-nanoparticles-as-multifunctional-drug-carriers-for-cancer-combination-therapy
#8
Elham Zakerzadeh, Roya Salehi, Mehrdad Mahkam
Due to multidrug resistance of cancer tissues and immune-suppression of cancerous patients during chemotherapy in one hand and the use of tetrazole derivatives in medicine because of its anticancer, antifungal and antiviral properties, on the other, we were encouraged to design novel smart antibacterial nanocomposites-based polymer of tetrazole as dual anticancer drug delivery systems. The structures of nanocomposites characterized by FTIR, (1)H NMR, FESEM-EDX and TGA analyses and antibacterial activity of smart carriers were evaluated by determination of minimum inhibitory concentration (MIC) values against some bacteria and fungi...
July 20, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28702763/pharmacokinetics-of-antifungal-drugs-practical-implications-for-optimized-treatment-of-patients
#9
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/28696236/combination-therapy-with-isavuconazole-and-micafungin-for-treatment-of-experimental-invasive-pulmonary-aspergillosis
#10
Vidmantas Petraitis, Ruta Petraitiene, Matthew W McCarthy, Laura L Kovanda, Myo H Zaw, Kaiser Hussain, Naima Shaikh, Bo Bo W Maung, Navjot K Sekhon, William W Hope, Thomas J Walsh
Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in immunocompromised patients. We hypothesized that simultaneous inhibition of biosynthesis of ergosterol in the fungal cell membrane and (1→3)-β-D-glucan in the cell wall, respectively, by the antifungal triazole isavuconazole and the echinocandin micafungin, may result in improved outcome in experimental IPA in persistently neutropenic rabbits. Treatment groups included isavuconazole (ISA) at 20 (ISA20), 40 (ISA40), and 60 (ISA60) mg/kg/day, micafungin at 2 mg/kg/day (MFG2), or combinations of (ISA20+MFG2), (ISA40+MFG2), (ISA60+MFG2), and untreated rabbits (UC)...
July 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28694566/antifungal-resistance-metabolic-routes-as-drug-targets-and-new-antifungal-agents-an-overview-about-endemic-dimorphic-fungi
#11
REVIEW
Juliana Alves Parente-Rocha, Alexandre Melo Bailão, André Correa Amaral, Carlos Pelleschi Taborda, Juliano Domiraci Paccez, Clayton Luiz Borges, Maristela Pereira
Diseases caused by fungi can occur in healthy people, but immunocompromised patients are the major risk group for invasive fungal infections. Cases of fungal resistance and the difficulty of treatment make fungal infections a public health problem. This review explores mechanisms used by fungi to promote fungal resistance, such as the mutation or overexpression of drug targets, efflux and degradation systems, and pleiotropic drug responses. Alternative novel drug targets have been investigated; these include metabolic routes used by fungi during infection, such as trehalose and amino acid metabolism and mitochondrial proteins...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28688551/pediatric-invasive-fungal-rhinosinusitis-an-investigation-of-17-patients
#12
Daniel Vinh, Michael Yim, Ankhi Dutta, John K Jones, Wei Zhang, Matthew Sitton
PURPOSE: To investigate outcomes of pediatric patients at a single institution with invasive fungal rhinosinusitis (IFRS) and to determine variables that impact overall survival. METHODS: All pediatric patients at a large tertiary children's hospital diagnosed with IFRS confirmed by surgical pathology from 2009 to 2015 were retrospectively reviewed. Demographics, underlying diseases, symptoms, antifungal therapy, absolute neutrophil count (ANC), surgical management,and outcomes were analyzed...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28685145/oral-candida-in-patients-with-fixed-orthodontic-appliance-in-vitro-combination-therapy
#13
Wisam Alhamadi, Rafal J Al-Saigh, Nebras N Al-Dabagh, Hussam W Al-Humadi
BACKGROUND: Fixed orthodontic appliance (FOA) increases the cariogenic microorganisms of mouth including candida. The aim was to evaluate the pharmacodynamic effects of some antibacterial drugs in combination with most applicable antifungal agents on candida isolated from patients with FOA. METHODS: Three antifungal agents (amphotericin B (AMB), ketoconazole (KET), and itraconazole (ITZ)) and three antibacterial drugs (ciprofloxacin (CIP), doxycycline (DOX), and metronidazole (MET)) with serial concentrations have been used and microdilution broth method has been done for single and combination therapy, then fungal growth was assessed spectrophotometrically, and the combinations were evaluated by bliss independent analysis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28680034/high-dose-fluconazole-in-combination-with-amphotericin-b-is-more-efficient-than-monotherapy-in-murine-model-of-cryptococcosis
#14
Julliana Ribeiro Alves Santos, Noelly Queiroz Ribeiro, Rafael Wesley Bastos, Rodrigo Assunção Holanda, Letícia Chagas Silva, Estela Rezende Queiroz, Daniel Assis Santos
Cryptococcus spp., the causative agents of cryptococcosis, are responsible for deaths of hundreds of thousands of people every year worldwide. The drawbacks of available therapeutic options are aggravated by the increased resistance of yeast to the drugs, resulting in inefficient therapy. Also, the antifungal 5FC is not available in many countries. Therefore, a combination of antifungal drugs may be an interesting option, but in vitro and theoretical data point to the possible antagonism between the main antifungals used to treat cryptococcosis, i...
July 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28673609/strong-synergism-of-dexamethasone-in-combination-with-fluconazole-against-resistant-candida-albicans-mediated-by-inhibiting-drug-efflux-and-reducing-virulence
#15
Wenwen Sun, Decai Wang, Cuixiang Yu, Xin Huang, Xiuyun Li, Shujuan Sun
Candida albicans is the most commonly isolated Candida spp. in the clinic and its resistance to fluconazole (FLC) has been emerging rapidly. Combination therapy may be a potentially effective approach to combat drug resistance. In this study, the combination antifungal effects of dexamethasone (DXM) and FLC against resistant C. albicans in vitro were assayed using minimum inhibitory concentrations (MICs), sessile MICs and time-kill curves. The in vivo efficacy of this drug combination was evaluated using a Galleria mellonella model by determining survival rate, fungal burden and histological damage...
June 30, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28671171/early-onset-de-novo-invasive-pulmonary-aspergillosis-in-an-orthotopic-heart-transplant-recipient
#16
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/28650761/cryptococcal-osteomyelitis-of-the-first-metatarsal-head-in-an-immunocompetent-patient
#17
Jae Hoon Ahn, ChanJoo Park, Choong Woo Lee, Yoon-Chung Kim
Most fungal infections primarily occur in immunocompromised patients. We describe a case of osteomyelitis involving the first metatarsal head due to Cryptococcus neoformans in a previously healthy immunocompetent patient. She was treated with surgical debridement combined with antifungal drug therapy for 6 months. At 5-year follow-up, she remained symptom free with full range of motion of the first metatarsophalangeal joint. Fungal osteomyelitis should be considered as a possible cause in osteolytic lesions in the metatarsal bone...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28645774/evaluation-of-selected-indian-medicinal-plants-for-antagonistic-potential-against-malassezia-spp-and-the-synergistic-effect-of-embelin-in-combination-with-ketoconazole
#18
Chandran Sivasankar, Subramanian Gayathri, James Prabhanand Bhaskar, Venkat Krishnan, Shunmugiah Karutha Pandian
The genus Malassezia comprises of extremely lipophilic yeasts secreting lipases as a vital factor for survival. They are emerging as opportunistic pathogens in medical microbiology and dermatology by causing recurring and recalcitrant infection. Combinatorial therapy is a constructive way to combat infectious diseases. In that prospect, totally 16 Indian medicinal plants were screened, among which a maximum degree of antimicrobial activity was ascertained in Embelia ribes. Subsequently embelin was identified as the bioactive principle with antagonistic potential by comparative antimicrobial assay and FTIR analysis...
June 20, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28638374/azole-resistance-in-aspergillus-fumigatus-a-consequence-of-antifungal-use-in-agriculture
#19
REVIEW
Sarah Berger, Yassine El Chazli, Ambrin F Babu, Alix T Coste
Agricultural industry uses pesticides to optimize food production for the growing human population. A major issue for crops is fungal phytopathogens, which are treated mainly with azole fungicides. Azoles are also the main medical treatment in the management of Aspergillus diseases caused by ubiquitous fungi, such as Aspergillus fumigatus. However, epidemiological research demonstrated an increasing prevalence of azole-resistant strains in A. fumigatus. The main resistance mechanism is a combination of alterations in the gene cyp51A (TR34/L98H)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28636889/complications-of-hematopoietic-stem-transplantation-fungal-infections
#20
REVIEW
Ali S Omrani, Reem S Almaghrabi
Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
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