Review Article
Systemic mycoses in the immunocompromised host: an update in antifungal therapy

https://doi.org/10.1053/jhin.2002.1278Get rights and content

Abstract

Despite significant advances in the management of immunosuppressed patients, invasive fungal infections remain an important life-threatening complication. In the last decade several new antifungal agents, including compounds in pre-existing classes (new generation of triazoles, polyenes in lipid formulations) and novel classes of antifungals with a unique mechanism of action (echinocandins), have been introduced in clinical practice. Ongoing and future studies will determine their exact role in the management of different mycoses. The acceleration of antifungal drug discovery offers promise for the management of these difficult to treat opportunistic infections.

References (167)

  • DW Denning

    Treatment of invasive aspergillosis

    J Infect

    (1994)
  • AH Groll et al.

    Clinical pharmacology of systemic antifungal agents: a comprehensive review of agents in clinical use, current investigational compounds, and putative targets for antifungal drug development

    Adv Pharmacol

    (1998)
  • SE Vartivarian et al.

    Emerging fungal pathogens in immunocompromised patients: classification, diagnosis, and management

    Clin Infect Dis

    (1993)
  • TJ Walsh et al.

    Emerging fungal pathogens: evolving challenges to immunocompromised patients for the twenty-first century

    Transpl Infect Dis

    (1999)
  • MM McNeil et al.

    Trends in mortality due to invasive mycotic diseases in the United States, 1980–1997

    Clin Infect Dis

    (2001)
  • PA Pizzo

    Management of fever in patients with cancer and treatment-induced neutropenia

    N Engl J Med

    (1993)
  • EC Williamson et al.

    Infections in adults undergoing unrelated donor bone marrow transplantation

    Br J Haematol

    (1999)
  • HM Blumberg et al.

    National Epidemiology of Mycoses Survey (NEMIS) Study Group. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study

    Clin Infect Dis

    (2001)
  • L Saiman et al.

    Risk factors for candidemia in Neonatal Intensive Care Unit patients

    Pediatr Infect Dis J

    (2000)
  • PH Chandrasekar et al.

    Aspergillus: an increasing problem in tertiary care hospitals?

    Clin Infect Dis

    (2000)
  • JR Rees et al.

    The epidemiological features of invasive mycotic infections in the San Francisco bay area, 1992–1993: results of population based laboratory active surveillance

    Clin Infect Dis

    (1998)
  • DW Denning et al.

    Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases

    Rev Infect Dis

    (1990)
  • R Ruchel

    Diagnosis of invasive mycoses in severely immunosuppressed patients

    Ann Hematol

    (1993)
  • MD Richardson et al.

    New perspectives in the diagnosis of systemic fungal infections

    Ann Med

    (1999)
  • HA Gallis et al.

    Amphotericin B: 30 years of clinical experience

    Rev Infect Dis

    (1990)
  • GP Bodey

    Azole antifungal agents

    Clin Infect Dis

    (1992)
  • A Vermes et al.

    Flucytosine: a review of its pharmacology, clinical indications, pharmacokinetics, toxicity and drug interactions

    J Antimicrob Chemother

    (2000)
  • NJ Galgiani

    Fluconazole, a new antifungal agent

    Ann Intern Med

    (1990)
  • SM Grant et al.

    Fluconazole. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial and systemic mycoses

    Drugs

    (1990)
  • M Boogaerts et al.

    Clinical experience with itraconazole in systemic fungal infections

    Drugs

    (2001)
  • DP Kontoyiannis

    A clinical perspective for the management of invasive fungal infections: focus on IDSA guidelines

    Pharmacotherapy

    (2001)
  • JR Wingard et al.

    Clinical significance of nephrotoxicity in patients treated with amphotericin B for suspected or proven aspergillosis

    Clin Infect Dis

    (1999)
  • JW Hiemenz et al.

    Lipid formulations of amphotericin B: recent progress and future directions

    Clin Infect Dis

    (1996)
  • JP Adler-Moore et al.

    Development, characterization, efficacy and mode of action of AmBisome, a unilammelar liposomal formulation of amphotericin B

    J Liposome Res

    (1993)
  • AS Janoff et al.

    Amphotericin B lipid complex (ABLC™): a molecular rationale for the attenuation of amphotericin B-related toxicities

    J Liposome Res

    (1993)
  • KV Clemons et al.

    Comparison of Fungizone, Amphotec, Am-Bisome, and Abelcet for treatment of systemic murine cryptococcosis

    Antimicrob Agents Chemother

    (1998)
  • R Janknegt et al.

    Liposomal and lipid formulations of amphotericin B. Clinical pharmacokinetics

    Clin Pharmacokinet

    (1992)
  • O Ringden et al.

    Efficacy of amphotericin B encapsulated in liposomes (AmBisome) in the treatment of invasive fungal infections in immunocompromised patients

    J Antimicrob Chemother

    (1991)
  • TT Ng et al.

    Liposomal amphotericin B (AmBisome) therapy in invasive fungal infections: evaluation of United Kingdom compassionate use data

    Arch Intern Med

    (1995)
  • W Mills et al.

    Liposomal amphotericin B in the treatment of fungal infections in neutropenic patients: a single center experience of 133 episodes in 116 patients

    Br J Haematol

    (1994)
  • TJ Walsh et al.

    Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases

    Clin Infect Dis

    (1998)
  • BA Oppenheim et al.

    The safety and efficacy of amphotericin B colloidal dispersion in the treatment of invasive mycoses

    Clin Infect Dis

    (1995)
  • GA Noskin et al.

    Amphotericin B colloidal dispersion for the treatment of candidemia in immunocompromised patients

    Clin Infect Dis

    (1998)
  • AC Leenders et al.

    Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia-associated invasive fungal infections

    Br J Haematol

    (1998)
  • HG Prentice et al.

    A randomized comparison of liposomal versus conventional amphotericin B for the treatment of pyrexia of unknown origin in neutropenic patients

    Br J Haematol

    (1997)
  • TJ Walsh et al.

    for the National Institute of Allergy and Infectious Diseases Mycoses Study Group. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia

    N Engl J Med

    (1999)
  • HK Johansen et al.

    Amphotericin B lipid soluble formulations vs amphotericin B in cancer patients with neutropenia

    Cochrane Database Syst Rev

    (2000)
  • P Moreau et al.

    Reduced renal toxicity and improved clinical tolerance of amphotericin B mixed with intralipid compared with conventional amphotericin B in neutropenic patients

    J Antimicrob Chemother

    (1992)
  • D Caillot et al.

    A controlled trial of the tolerance of amphotericin B infused in dextrose or in Intralipid in patients with haematological malignancies

    J Antimicrob Chemother

    (1994)
  • B Pascual et al.

    Administration of lipid-emulsion versus conventional amphotericin B in patients with neutropenia

    Ann Pharmacother

    (1995)

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    Author for correspondence: Dr Dimitrios P. Kontoyiannis, Department of Infectious Diseases, Infection Control and Employee Health, Box 402, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. Tel.: 713-792-6237; Fax: 713-745-6839; E-mail: [email protected]

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    Copyright © 2003 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.