In vitro interactions between amphotericin B and other antifungal agents and rifampin against Fusarium spp.

Spader, Tatiana; Venturini, Tarcieli Pozzebon; Cavalheiro, Ayrton Sydnei; Mahl, Camila D.; Mário, Débora Nunes; Lara, Valéria Maria; Santúrio, Jânio Morais; Alves, Sydney Hartz

doi:10.1111/j.1439-0507.2009.01773.x

Cited by 20 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We demonstrated that TRB showed poor activity against Fusarium species causing onychomycosis. Previous studies have shown a significant variation of the pattern of TRB susceptibility against Fusarium where 25% of the isolates showed MICs equal to 2.0 μg/mL, 25% had MICs of 4.0 μg/mL and 50% had MICs greater than or equal to 16 μg/mL . In another study, the highest MICs of most of the antifungal agents including TRB were those against Fusarium spp., except for griseofulvin, whose MICs against all the others NDFF were >64 μg/mL .…”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis

Rosa

Heidrich

Corrêa

et al. 2017

Mycoses

View full text Add to dashboard Cite

Fusarium species have emerged as an important human pathogen in skin disease, onychomycosis, keratitis and invasive disease. Onychomycosis caused by Fusarium spp. The infection has been increasingly described in the immunocompetent and immunosuppressed hosts. Considering onychomycosis is a difficult to treat infection, and little is known about the genetic variability and susceptibility pattern of Fusarium spp., further studies are necessary to understand the pathogenesis and better to define the appropriate antifungal treatment for this infection. Accordingly, the objective of this study was to describe the in vitro susceptibility to different antifungal agents and the genetic diversity of 35 Fusarium isolated from patients with onychomycosis. Fusarium spp. were isolated predominantly from female Caucasians, and the most frequent anatomical location was the nail of the hallux. Results revealed that 25 (71.4%) of isolates belonged to the Fusarium solani species complex, followed by 10 (28.5%) isolates from the Fusarium oxysporum species complex. Noteworthy, the authors report the first case of Neocosmospora rubicola isolated from a patient with onychomycosis. Amphotericin B was the most effective antifungal agent against the majority of isolates (60%, MIC ≤4 μg/mL), followed by voriconazole (34.2%, MIC ≤4 μg/mL). In general, Fusarium species presented MIC values >64 μg/mL for fluconazole, itraconazole and terbinafine. Accurate pathogen identification, characterisation and susceptibility testing provide a better understanding of pathogenesis of Fusarium in onychomycosis.

show abstract

Section: Discussionmentioning

confidence: 83%

mentioning

confidence: 91%

Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis

Rosa

Heidrich

Corrêa

et al. 2017

Mycoses

View full text Add to dashboard Cite

show abstract

“…Itraconazole itself has poor in vitro activity against Fusarium species. 16,110 Nevertheless, the use of aerosolized amphotericin B deoxycholate with itraconazole might be a more appropriate approach because it has good activity against Aspergillus species, Fusarium species, and Candida species, among others. 2,23,60,63,89,90,98 The drug-drug interactions associated with itraconazole should, however, be taken into account.…”

Section: Treatmentmentioning

confidence: 99%

Fusarium Infection in Lung Transplant Patients

et al. 2011

View full text Add to dashboard Cite

Fusarium is a fungal pathogen of immunosuppressed lung transplant patients associated with a high mortality in those with severe and persistent neutropenia. The principle portal of entry for Fusarium species is the airways, and lung involvement almost always occurs among lung transplant patients with disseminated infection. In these patients, the immunoprotective mechanisms of the transplanted lungs are impaired, and they are, therefore, more vulnerable to Fusarium infection. As a result, fusariosis occurs in up to 32% of lung transplant patients. We studied fusariosis in 6 patients following lung transplantation who were treated at Massachusetts General Hospital during an 8-year period and reviewed 3 published cases in the literature. Cases were identified by the microbiology laboratory and through discharge summaries. Patients presented with dyspnea, fever, nonproductive cough, hemoptysis, and headache. Blood tests showed elevated white blood cell counts with granulocytosis and elevated inflammatory markers. Cultures of Fusarium were isolated from bronchoalveolar lavage, blood, and sputum specimens. Treatments included amphotericin B, liposomal amphotericin B, caspofungin, voriconazole, and posaconazole, either alone or in combination. Lung involvement occurred in all patients with disseminated disease and it was associated with a poor outcome. The mortality rate in this group of patients was high (67%), and of those who survived, 1 patient was treated with a combination of amphotericin B and voriconazole, 1 patient with amphotericin B, and 1 patient with posaconazole. Recommended empirical treatment includes voriconazole, amphotericin B or liposomal amphotericin B first-line, and posaconazole for refractory disease. High-dose amphotericin B is recommended for treatment of most cases of fusariosis. The echinocandins (for example, caspofungin, micafungin, anidulafungin) are generally avoided because Fusarium species have intrinsic resistance to them. Treatment should ideally be based on the Fusarium isolate, susceptibility testing, and host-specific factors. Prognosis of fusariosis in the immunocompromised is directly related to a patient’s immune status. Prevention of Fusarium infection is recommended with aerosolized amphotericin B deoxycholate, which also has activity against other important fungi.

show abstract

“…The intrinsic resistance of Fusarium species to most antifungals leads to high mortality rates in patients with invasive fusariosis. Despite the concerns about in vitro antagonism between polyenes and azoles, some studies have shown in vitro synergism of voriconazole and L-AMB against Fusarium [25]. Based on such studies and on few clinical reports of success in the treatment of invasive fusariosis with the association of L-AMB with voriconazole, some authors support CAT for fusariosis [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Combination Antifungal Therapy for Invasive Mold Infections Among Pediatric Patients with Hematological Malignancies: Data from A Real-Life Case-Series

Peri

Verna

Biffi

et al. 2019

PAI

View full text Add to dashboard Cite

Background: Invasive mold infections in children with hematological malignancies are associated with high mortality rates. The use of combination antifungal therapy in cases with a severe clinical course is increasing, although information on the efficacy and safety of this approach is limited.Methods: We present a case series of 13 children affected by hemato-oncological disorders who received combination antifungal therapy for invasive mold infections at our center (Pediatric Hematology, San Gerardo Hospital, Monza, Italy) from 2011 to 2016, with the aim of describing their clinical characteristics, types of infections, treatment regimens, clinical outcomes, and treatment safety. Medical records were retrospectively reviewed in order to describe patients’ characteristics.Results: Combination antifungal therapy included liposomal amphotericin associated with caspofungin (5/13, 38.4%), voriconazole (5/13, 38.4%), or posaconazole (3/13, 23.1%). The 12-week treatment response rate was 69.2% (6/13 patients showed complete response, 3/13 partial response). The crude mortality was 30.7% (4/13): half was related to invasive mold infections (2/13, 15.38%) and half to disease progression (2/13, 15.38%). Overall, treatment was well tolerated, and we did not observe any permanent discontinuation of antifungals due to related side effects.Conclusions: In our experience, combination antifungal therapy seems to be a safe option in immunocompromised children with invasive mold infections. Well-designed studies are needed to confirm the safety of this approach and to better understand its efficacy in the pediatric setting.Keywords: antifungal therapy; mold; hematological malignancies

show abstract

In vitro interactions between amphotericin B and other antifungal agents and rifampin against Fusarium spp.

Cited by 20 publications

References 18 publications

Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis

Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis

Fusarium Infection in Lung Transplant Patients

Combination Antifungal Therapy for Invasive Mold Infections Among Pediatric Patients with Hematological Malignancies: Data from A Real-Life Case-Series

Contact Info

Product

Resources

About