Therapy of invasive fungal infections

Neth J Med. 1999 Sep;55(3):118-27. doi: 10.1016/s0300-2977(99)00022-4.

Abstract

During the past decades, the incidence and severity of invasive fungal infections has been increasing. These events have lead to the development of new antifungal agents, and amphotericin B no longer is the standard therapy for a variety of invasive mycoses. Fluconazole has become the drug of choice for treatment of C. albicans infections in non-neutropenic as well as neutropenic patients. For treatment of cryptococcal meningitis, amphotericin B with flucytosine, followed by fluconazole consolidation therapy is used. For therapy of invasive aspergillosis, the lipid formulations of amphotericin B may be associated with reduced toxicity and allow for larger doses, although the efficacy of each of the formulations still has to be established in randomized trials. Finally, treatment modalities aimed at improving host defense mechanisms, including adjunctive therapy with rG-CSF for disseminated candidiasis and rG-CSF-elicited granulocyte transfusions, are under way.

Publication types

  • Review

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Catheterization, Central Venous
  • Contraindications
  • Drug Therapy, Combination
  • Flucytosine / therapeutic use
  • Fungemia / microbiology
  • Granulocyte Colony-Stimulating Factor / immunology
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Immunotherapy / methods*
  • Mycoses / drug therapy
  • Mycoses / therapy*
  • Neutropenia / chemically induced
  • Triazoles / therapeutic use

Substances

  • Antifungal Agents
  • Triazoles
  • Granulocyte Colony-Stimulating Factor
  • Amphotericin B
  • Flucytosine