Salvage treatment of histoplasmosis with posaconazole

Restrepo, Ángela; Tobón, Ángela M.; Clark, Benjamin M.; Graham, Donald R.; Corcoran, Gavin; Bradsher, Robert W.; Goldman, Mitchell; Pankey, George A.; Moore, Thomas; Negroni, Ricardo; Graybill, John R.

doi:10.1016/j.jinf.2006.05.006

Cited by 125 publications

(59 citation statements)

References 28 publications

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“…Posaconazole has fewer cytochrome P450 interactions than other azoles and is an attractive alternative, but experience with this triazole for treating histoplasmosis is limited. 24 In addition, there have been reports of decreased serum levels of posaconazole and clinical failure when used concomitantly with rifampicin. 25 An option that may prove superior to any of the above options is to replace rifampicin with moxifloxacin.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis and Histoplasmosis Co-Infection in AIDS Patients

Agudelo¹,

Restrepo²,

Molina³

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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Abstract. Coinfection with tuberculosis in some countries occurs in 8-15% of human immunodeficiency virus (HIV) -infected patients who have histoplasmosis. This coinfection interferes with prompt diagnosis, and treatment is difficult because of drug interactions. We retrospectively reviewed the cases of 14 HIV-infected patients who had concomitant tuberculosis and histoplasmosis. The most frequent clinical manifestations were weight loss (85.7%), asthenia (78.5%), and fever (64.2%). The diagnosis of histoplasmosis was made primarily by histopathology (71.4%), and the diagnosis of tuberculosis was made by means of direct microscopic examination (71.4%). Death occurred in two patients, and relapse of both infections occurred in one patient. Moxifloxacin was substituted for rifampicin in six patients, with good outcomes noted for both infections. The clinical presentation does not readily identify acquired immunodeficiency syndrome (AIDS) patients who have tuberculosis and histoplasmosis. The use of a fluoroquinolone as an alternative agent in place of rifampicin for tuberculosis allows effective therapy with itraconazole for histoplasmosis.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis and Histoplasmosis Co-Infection in AIDS Patients

Agudelo¹,

Restrepo²,

Molina³

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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“…Antigen levels should continue to be monitored at 3-month intervals during suppressive therapy. Voriconazole, posaconazole and fluconazole may be considered as alternatives to itraconazole (64,65,74) (Table 4). Fluconazole is the least active of the azoles for histoplasmosis but has been used successfully for the treatment and may be the best alternative in patients with itraconazole intolerance.…”

Section: Treatment Of Histoplasmosis Is Summarized Inmentioning

confidence: 99%

Donor-Derived Fungal Infections in Organ Transplant Recipients: Guidelines of the American Society of Transplantation, Infectious Diseases Community of Practice

Singh

Huprikar

Burdette

et al. 2012

American Journal of Transplantation

149

154

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“…In vitro, voriconazole may be as active as, or perhaps slightly (1,11,(23)(24)(25) with voriconazole, although failure has also been reported, with subsequent response to posaconazole (21). Cross-resistance between fluconazole and voriconazole has been described in H. capsulatum isolates from patients infected with human immunodeficiency virus (26).…”

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confidence: 99%