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antifungal combination therapy

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28621668/blocking-epithelial-to-mesenchymal-transition-in-glioblastoma-with-a-sextet-of-repurposed-drugs-the-eis-regimen
#4
Richard E Kast, Nicolas Skuli, Georg Karpel-Massler, Guido Frosina, Timothy Ryken, Marc-Eric Halatsch
This paper outlines a treatment protocol to run alongside of standard current treatment of glioblastoma- resection, temozolomide and radiation. The epithelial to mesenchymal transition (EMT) inhibiting sextet, EIS Regimen, uses the ancillary attributes of six older medicines to impede EMT during glioblastoma. EMT is an actively motile, therapy-resisting, low proliferation, transient state that is an integral feature of cancers' lethality generally and of glioblastoma specifically. It is believed to be during the EMT state that glioblastoma's centrifugal migration occurs...
June 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28620270/flucytosine-and-amphotericin-b-coadministration-induces-dose-related-renal-injury
#5
Alexandra Folk, Cornel Balta, Hildegard Herman, Alexandra Ivan, Oana Maria Boldura, Lucian Paiusan, Aurel Ardelean, Anca Hermenean
Invasive fungal infections remain an important clinical problem, and despite recent approaches, they bring high morbidity and mortality. Combination therapies are the most effective; however, adverse effects need to be considered. In this study, we aimed to evaluate the nephrotoxicity induced by combined therapy of flucytosine (FL) and amphotericin B (AMF) at 3 different doses administered to mice for 14 days: 300 μg/kg AMF+50 mg/kg FL; 600 μg/kg AMF+100 mg/kg FL; 900 μg/kg AMF+150 mg/kg FL. Antifungal coadministration triggered nuclear translocation of NF-κB and upregulated nuclear factor kappa-light-chain-enhancer of activated B cells subunit p65 (NF-κB p65) messenger RNA mRNA level in dose-dependent manner...
April 2017: Dose-response: a Publication of International Hormesis Society
https://www.readbyqxmd.com/read/28617137/drugs-currently-under-investigation-for-the-treatment-of-invasive-candidiasis
#6
Matthew W McCarthy, Thomas J Walsh
The widespread implementation of immunosuppressants, immunomodulators, hematopoietic stem cell transplantation and solid organ transplantation in clinical practice has led to an expanding population of patients who are at risk for invasive candidiasis, which is the most common form of fungal disease among hospitalized patients in the developed world. The emergence of drug-resistant Candida spp. has added to the morbidity associated with invasive candidiasis and novel therapeutic strategies are urgently needed...
June 15, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28593476/synergy-between-azoles-and-1-4-dihydropyridine-derivative-as-an-option-to-control-fungal-infections
#7
Zuzana Ježíková, Tomáš Pagáč, Barbora Pfeiferová, Helena Bujdáková, Stanislava Dižová, Iva Jančíková, Dana Gášková, Petra Olejníková
With emerging fungal infections and developing resistance, there is a need for understanding the mechanisms of resistance as well as its clinical impact while planning the treatment strategies. Several approaches could be taken to overcome the problems arising from the management of fungal diseases. Besides the discovery of novel effective agents, one realistic alternative is to enhance the activity of existing agents. This strategy could be achieved by combining existing antifungal agents with other bioactive substances with known activity profiles (combination therapy)...
June 7, 2017: Antonie Van Leeuwenhoek
https://www.readbyqxmd.com/read/28577122/successful-treatment-of-pulmonary-mucormycosis-caused-by-cunninghamella-bertholletiae-with-high-dose-liposomal-amphotericin-b-10%C3%A2-mg-kg-day-followed-by-a-lobectomy-in-cord-blood-transplant-recipients
#8
Hikari Ota, Hisashi Yamamoto, Muneyoshi Kimura, Hideki Araoka, Takeshi Fujii, Takashi Umeyama, Hideaki Ohno, Yoshitsugu Miyazaki, Daisuke Kaji, Yuki Taya, Aya Nishida, Kazuya Ishiwata, Masanori Tsuji, Shinsuke Takagi, Yuki Asano-Mori, Go Yamamoto, Naoyuki Uchida, Koji Izutsu, Kazuhiro Masuoka, Atsushi Wake, Akiko Yoneyama, Shigeyoshi Makino, Shuichi Taniguchi
Infection caused by Cunninghamella bertholletiae carries one of the highest mortality rates among mucormycosis, and there are no reported cases that survived from the infection in allogeneic hematopoietic stem cell transplantation recipients occurring before neutrophil engraftment. Here, we present two cases of pulmonary mucormycosis caused by C. bertholletiae occurring before neutrophil engraftment after cord blood transplantation. Both were successfully treated with high-dose liposomal amphotericin B (10 mg/kg/day) combined with micafungin, which was then followed by neutrophil recovery, reduction in immunosuppressive agents, and a subsequent lobectomy...
June 2, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28568285/claviform-aspergillus-related-vegetation-in-the-left-ventricle-of-a-patient-with-systemic-lupus-erythematosus
#9
Tetsushi Yamamoto, Shimpei Kasagi, Chiyo Kurimoto, Takamitsu Imanishi, Nobuhide Hayashi, Akio Morinobu, Jun Saegusa
A 38-year-old woman was diagnosed with systemic lupus erythematosus and received immunosuppressive therapy. After 6 months of treatment, workup for low-grade fever yielded elevated enzyme-linked immunosorbent assay titers for Aspergillus antigen in serum and ascites, leading to the diagnosis of disseminated aspergillosis. Transthoracic echocardiography revealed a claviform vegetation attached to the left ventricular anterior septum. Two days after the start of antifungal Amphotericin-B therapy, the patient suffered from several neurologic disorders...
June 1, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28556426/retrospective-study-on-the-incidence-and-outcome-of-proven-and-probable-invasive-fungal-infections-in-high-risk-pediatric-onco-hematological-patients
#10
Simone Cesaro, Gloria Tridello, Elio Castagnola, Elisabetta Calore, Francesca Carraro, Ilaria Mariotti, Antonella Colombini, Katia Perruccio, Nunzia Decembrino, Giovanna Russo, Natalia Maximova, Valentina Baretta, Désirée Caselli
BACKGROUND: invasive fungal infection (IFI) is a cause of morbidity, mortality and increased health costs in children undergoing chemotherapy or hematopoietic stem cell transplant (HSCT). METHODS: multi-center, retrospective study to assess the incidence, outcome of proven and probable IFI (PP-IFI) in children treated for acute leukemia, non-Hodgkin lymphoma or who underwent HSCT from 2006 to 2012. RESULTS: Over the 7-year period, 127 PP-IFI were diagnosed in 123 patients, median age of 9...
May 27, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28556195/use-of-nystatin-and-chlorhexidine-in-oral-medicine-properties-indications-and-pitfalls-with-focus-on-geriatric-patients
#11
REVIEW
Elusa Scheibler, Maria Claudia Rosa Garcia, Renata Medina da Silva, Maria Antonia Figueiredo, Fernanda Gonçalves Salum, Karen Cherubini
OBJECTIVES: The aim of this work was to review the scientific literature on the properties, indications and pitfalls related to nystatin and chlorhexidine in oral medicine and also to compare these to other topical antifungal agents, considering the elderly population. BACKGROUND: Nystatin is a polyene antifungal widely used as a topical formulation to treat candidiasis, whereas chlorhexidine is a wide-spectrum antimicrobial, especially used against bacteria, but also effective in treating some fungal infections including those caused by Candida spp...
May 29, 2017: Gerodontology
https://www.readbyqxmd.com/read/28555254/successful-antifungal-combination-therapy-and-surgical-approach-for-aspergillus-fumigatus-suppurative-thyroiditis-associated-with-thyrotoxicosis-and-review-of-published-reports
#12
S Nicolè, M Lanzafame, A Cazzadori, M Vincenzi, F Mangani, C Colato, G El Dalati, P Brazzarola, E Concia
In immunocompromised patients, Aspergillus infections are important causes of morbidity and mortality. We describe a patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus. The diagnosis was based upon radiological, microbiological and pathological findings. The patient was treated successfully with voriconazole and caspofungin treatment followed by total thyroidectomy. We provide an overview of published reports on Aspergillus thyroiditis with an emphasis on therapeutic approaches...
May 29, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28552257/-allergic-bronchopulmonary-aspergillosis-evaluation-of-a-maintenance-therapy-with-nebulized-ambisome-%C3%A2
#13
C Godet, F Couturaud, S Ragot, F Laurent, A L Brun, A Bergeron, J Cadranel
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) affects 3-13% of patients with asthma. Its natural history includes possibly life-threatening exacerbations and evolution towards fixed obstructive ventilatory disorders or even irreversible lung fibrosis lesions. ABPA prognosis is directly associated with exacerbation control and the main objective of the treatment is to decrease their frequency and duration. Recommendations regarding dosage and duration of treatment are not very precise...
May 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28545901/management-of-aspergillus-pleural-empyema-with-combined-systemic-and-intrapleural-antifungal-therapy-in-a-pediatric-patient-case-report
#14
Alanoud Almuhareb, Zakaria Habib
We present the case of an 8-year-old immunocompromised boy with invasive pulmonary aspergillosis, complicated with pleural empyema and disseminated to the bone and central nervous system (CNS). The patient was treated with combined systemic antifungal agents (voriconazole and caspofungin) and intrapleural instillation of liposomal amphotericin B, in addition to surgical intervention. The treatment was well tolerated and resulted in remarkable clinical and radiological pulmonary improvement.
May 22, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28510690/trichosporonosis-in-pediatric-patients-with-a-hematologic-disorder
#15
Catherine E Foster, Morven S Edwards, Julienne Brackett, Deborah A Schady, C Mary Healy, Carol J Baker
Background.: Trichosporonosis is an emerging and often fatal opportunistic fungal infection in immunocompromised patients, particularly those with hematologic malignancy, but data in children are lacking. Methods.: We report here 3 cases of invasive infection caused by Trichosporon asahii in pediatric patients with acute lymphoblastic leukemia at Texas Children's Hospital in Houston, Texas. We also conducted a literature review and identified 16 additional reports of pediatric patients with invasive T asahii infection and an underlying malignant or nonmalignant hematologic disorder...
May 16, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28508242/preclinical-study-of-a-cost-effective-photodynamic-therapy-protocol-for-treating-oral-candidoses
#16
Nathalia Ramos da Silva, Daniela Garcia Ribeiro, João Paulo Mardegan Issa, Karla Bonfá, Michelli Sobreiro Menezes, Viviane de Cássia Oliveira, Raphael Freitas de Souza
Photodynamic therapy (PDT) is a promising treatment for oral candidoses. Its use as an alternative to antifungals prevents several adverse effects, including microbial resistance. However, most PDT protocols do not employ devices and consumables commonly available in dental practice, thus influencing treatment affordability. This study aimed to determine the efficacy of a PDT method based on light curing units' blue LEDs combined to a plaque-disclosing composition (5% erythrosine) against C. albicans in culture and in a murine model of oral candidosis...
May 15, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28503064/combined-intrastromal-injection-of-amphotericin-b-and-topical-fluconazole-in-the-treatment-of-resistant-cases-of-keratomycosis-a-retrospective-study
#17
Waled Mahdy Nada, Mahmoud A Al Aswad, Wael M El-Haig
PURPOSE: To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects. METHODS: This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28496543/combination-antifungal-therapy-a-review-of-current-data
#18
REVIEW
Marco Campitelli, Nabil Zeineddine, Ghassan Samaha, Stephen Maslak
The incidence of invasive fungal infections has been on the rise, particularly in transplant recipients and in patients with hematological malignancies and other forms of immunosuppression. There is a mismatch between the rate of antifungal resistance and the development of new antifungal agents. Based on this, the idea of combining antifungals in the treatment of invasive fungal infections appears tempting for many clinicians, particularly after many in vitro studies showed synergism between many antifungal agents...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28496146/the-antifungal-pipeline-a-reality-check
#19
REVIEW
John R Perfect
Invasive fungal infections continue to appear in record numbers as the immunocompromised population of the world increases, owing partially to the increased number of individuals who are infected with HIV and partially to the successful treatment of serious underlying diseases. The effectiveness of current antifungal therapies - polyenes, flucytosine, azoles and echinocandins (as monotherapies or in combinations for prophylaxis, or as empiric, pre-emptive or specific therapies) - in the management of these infections has plateaued...
May 12, 2017: Nature Reviews. Drug Discovery
https://www.readbyqxmd.com/read/28493896/candidemia-in-the-elderly-what-does-it-change
#20
Francesco Barchiesi, Elena Orsetti, Sara Mazzanti, Francesca Trave, Aldo Salvi, Cinzia Nitti, Esther Manso
BACKGROUND: Candidemia is a life-threatening fungal infection and it can affect patients of all ages. Characterization of candidemia in the elderly is lacking. METHODS: We performed a retrospective study of adults (≥ 18 years) with candidemia diagnosed in our center in 2010-2015. Demographics, comorbidities, clinical and microbiologic characteristics, antifungal treatment and outcome were compared between older (≤65 years) and younger (>65 years) patients...
2017: PloS One
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