Voriconazole combined with low-dose amphotericin B liposome for treatment of cryptococcal meningitis

Li, Shanshan; Tang, Xiaozhi; Zhang, Shengguo; Ni, Shun-Lan; Yang, Naibin; Lu, Mingqin

doi:10.3109/23744235.2016.1157897

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) guidelines recommend amphotericin B with or without flucytosine as initial therapy [ 19 ]. Our therapeutic choice was the association of voriconazole at loading doses (6 mg/kg two per day) and amphotericin-B 5 mg/kg/day, based on the few clinical studies—almost case reports—available in the literature [ 5 , 7 , 8 , 9 , 20 ], together with the close monitoring of laboratory and vital parameters. In these infections, the prompt recovery of blood counts seemed to be the only hope of survival in these patients, accompanied by the choice of therapy to guarantee a complete remission of the underlying hematological disease.…”

Section: Discussionmentioning

confidence: 99%

Saprochete capitata: Emerging Infections from Uncommon Microorganisms in Hematological Diseases

et al. 2022

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Infections occurring in immunocompromised patients after intensive chemotherapy are often difficult to eradicate and are capable of even being fatal. New emergent and dangerous drug-resistant micro-organisms are likely to appear in these specific scenarios. Clinical features mainly include progressive pneumonia, bacteriemia/fungemia, or extrapulmonary dissemination among infections. The treatment of these microorganisms is still an open challenge since there is a lack of clear treatment guidelines. Indeed, infections from these microorganisms can lead to a rapidly fatal clinical course in immunocompromised patients, especially those who have acute leukemia. We describe the case of a young patient with acute myeloid leukemia who contracted an infection from Saprochaete capitata during post-chemotherapy aplasia.

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Section: Discussionmentioning

confidence: 99%

Saprochete capitata: Emerging Infections from Uncommon Microorganisms in Hematological Diseases

et al. 2022

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“…VRZ is a triazole with a broad spectrum of antifungal activity but is not currently licensed for use for cryptococcosis. Case studies have demonstrated the successful treatment of CM with VRZ [19–22]. In vitro activities of VRZ [23, 24] show its better activity against Cryptococcus neoformans than itraconazole and FLZ, suggesting that VRZ is useful in the treatment of cryptococcosis.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcosis in Patients following Kidney Transplantation: A 9-Year Retrospective Clinical Analysis at a Chinese Tertiary Hospital

Yang

Zhang

et al. 2019

BioMed Research International

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Background Cryptococcosis following kidney transplantation (KT) is rare but is associated with considerably increased risk of mortality. At present, data on the association between cryptococcosis and KT in mainland China remain relatively limited. Objectives This study aims to review our experience related to the management of cryptococcosis following KT at a Chinese tertiary hospital. Methods All patients with cryptococcosis following KT admitted to our hospital from January 2010 to December 2018 were reviewed. Results A total of 37 patients with cryptococcosis were enrolled (males: 62.2%). The mean age of the patients was 49.5 ± 9.38 (20–64) years. The average time to infection following KT was 7.0 ± 5.50 years (5 months to 21 years), and 30 patients (81.1%) had cryptococcosis onset >2 years following transplantation. The most common site of infection was the central nervous system, followed by the pulmonary system and skin. Most patients received fluconazole or voriconazole with or without flucytosine as their initial treatment regimen at our hospital. The 2-week mortality rate was 8.1% (3/37), and five patients (13.5%) died within 6 months of being diagnosed with cryptococcosis. Remarkably, all patients who received high-dose fluconazole (800 mg daily) or voriconazole ± flucytosine survived. Conclusions Cryptococcosis in kidney transplant recipients is typically a late-occurring infection, with most patients having cryptococcosis onset >2 years following KT at our hospital. The central nervous system, pulmonary system, and skin are the main sites of infection. Voriconazole or high-dose fluconazole can be used as an alternative therapy for post-KT cryptococcosis.

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“…There was a significant increase in the BBB penetration of voriconazole. The drug was chosen because of its fungal cell membrane ergosterol disruption [17]. Currently, alternative novel fungal CYP inhibitors are being explored to improve the specificity to the target and to reduce toxicity.…”

Section: Lipid-based Nanocarriersmentioning

confidence: 99%

Progress in the Application of Nanoparticles and Graphene as Drug Carriers and on the Diagnosis of Brain Infections

et al. 2021

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The blood–brain barrier (BBB) is the protective sheath around the brain that protects the sensitive microenvironments of the brain. However, certain pathogens, viruses, and bacteria disrupt the endothelial barrier and cause infection and hence inflammation in meninges. Macromolecular therapeutics are unable to cross the tight junctions, thereby limiting their bioavailability in the brain. Recently, nanotechnology has brought a revolution in the field of drug delivery in brain infections. The nanostructures have high targeting accuracy and specificity to the receptors in the case of active targeting, which have made them the ideal cargoes to permeate across the BBB. In addition, nanomaterials with biomimetic functions have been introduced to efficiently cross the BBB to be engulfed by the pathogens. This review focuses on the nanotechnology-based drug delivery approaches for exploration in brain infections, including meningitis. Viruses, bacteria, fungi, or, rarely, protozoa or parasites may be the cause of brain infections. Moreover, inflammation of the meninges, called meningitis, is presently diagnosed using laboratory and imaging tests. Despite attempts to improve diagnostic instruments for brain infections and meningitis, due to its complicated and multidimensional nature and lack of successful diagnosis, meningitis appears almost untreatable. Potential for overcoming the difficulties and limitations related to conventional diagnostics has been shown by nanoparticles (NPs). Nanomedicine now offers new methods and perspectives to improve our knowledge of meningitis and can potentially give meningitis patients new hope. Here, we review traditional diagnosis tools and key nanoparticles (Au-NPs, graphene, carbon nanotubes (CNTs), QDs, etc.) for early diagnosis of brain infections and meningitis.

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Voriconazole combined with low-dose amphotericin B liposome for treatment of cryptococcal meningitis

Cited by 11 publications

References 12 publications

Saprochete capitata: Emerging Infections from Uncommon Microorganisms in Hematological Diseases

Saprochete capitata: Emerging Infections from Uncommon Microorganisms in Hematological Diseases

Cryptococcosis in Patients following Kidney Transplantation: A 9-Year Retrospective Clinical Analysis at a Chinese Tertiary Hospital

Progress in the Application of Nanoparticles and Graphene as Drug Carriers and on the Diagnosis of Brain Infections

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