Antifungal Resistance and the Role of New Therapeutic Agents.

IF 3.1 4区 医学 Q2 INFECTIOUS DISEASES
Current Infectious Disease Reports Pub Date : 2022-01-01 Epub Date: 2022-07-05 DOI:10.1007/s11908-022-00782-5
Ashley Logan, Amanda Wolfe, John C Williamson
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引用次数: 0

Abstract

Purpose of review: Advances in health care over time have led to an evolution in the epidemiology of invasive fungal infections. There is an increasing concern for antifungal resistance and emergence of less common fungal species for which optimal therapies are not well defined. The purpose of this review is to describe mechanisms of antifungal resistance and to evaluate the modern role of new and investigational antifungals.

Recent findings: Isavuconazole and ibrexafungerp represent the two newest antifungal agents. Evidence from in vivo and in vitro studies has been published recently to help define their place in therapy and potential roles in treating resistant fungi. Isavuconazole is a broad-spectrum triazole antifungal with evidence to support its use in invasive aspergillosis and mucormycosis. Its utility in treating voriconazole-resistant Candida should be confirmed with susceptibility testing if available. Ibrexafungerp is an oral glucan synthase inhibitor with little cross-resistance among currently available antifungals, including echinocandins. It is a promising new agent for invasive candidiasis, including azole-resistant Candida species, and in combination therapy with voriconazole for aspergillosis. Multiple antifungals, some with novel mechanisms, are in development, including rezafungin, oteseconazole, olorofim, fosmanogepix, and opelconazole.

Summary: Both isavuconazole and ibrexafungerp are welcome additions to the arsenal of antifungals, and the prospect of more antifungal options in the future is encouraging. Such an array of antifungals will be important as antifungal resistance continues to expand alongside evolving medical practices. However, managing resistant fungal infections will grow in complexity as the unique role of each new agent is defined.

Abstract Image

抗真菌抗药性和新治疗药物的作用。
综述的目的:随着时间的推移,医疗保健的进步导致了侵袭性真菌感染流行病学的演变。人们越来越关注抗真菌耐药性和不常见真菌种类的出现,而这些真菌种类的最佳疗法尚未明确。本综述旨在描述抗真菌耐药性的机制,并评估新的和正在研究的抗真菌药物的现代作用:最新发现:异唑康唑和伊曲康唑是两种最新的抗真菌药物。最近发表的体内和体外研究证据有助于确定它们在治疗中的地位以及在治疗耐药真菌方面的潜在作用。异武唑是一种广谱三唑类抗真菌药,有证据支持其用于侵袭性曲霉病和粘孢子菌病。在治疗对伏立康唑耐药的念珠菌时,应通过药敏试验(如果有的话)来确认其用途。Ibrexafungerp 是一种口服葡聚糖合成酶抑制剂,与目前可用的抗真菌药(包括棘白菌素类)之间几乎没有交叉耐药性。它是一种治疗侵袭性念珠菌病(包括耐唑念珠菌病)以及与伏立康唑联合治疗曲霉病的新型药物,前景广阔。多种抗真菌药物正在研发中,其中一些具有新的机制,包括雷扎芬净、奥特康唑、奥洛芬、福斯马诺格匹克和奥柏康唑。小结:异武康唑和伊布沙芬格尔普都是抗真菌药物库中值得欢迎的新成员,未来有更多抗真菌药物可供选择的前景令人鼓舞。随着医疗实践的不断发展,抗真菌药物的耐药性也在不断扩大,因此,抗真菌药物的多样性非常重要。然而,随着每种新药独特作用的确定,耐药性真菌感染的管理将变得越来越复杂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Infectious Disease Reports
Current Infectious Disease Reports INFECTIOUS DISEASES-
CiteScore
6.70
自引率
0.00%
发文量
19
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of infectious disease. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as HIV/AIDS, sexually transmitted diseases, tropical and travel medicine, and urinary tract infections. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists.
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