Medical mycology journal最新文献_第3页

Evaluation of Hepatic and Renal Function Algorithms for Fosravuconazole in Real-World Clinical Practice. 在现实世界的临床实践中评价福司伐康唑的肝肾功能算法。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.25-00042

Harunari Shimoyama, Yoshihiro Sei

{"title":"Evaluation of Hepatic and Renal Function Algorithms for Fosravuconazole in Real-World Clinical Practice.","authors":"Harunari Shimoyama, Yoshihiro Sei","doi":"10.3314/mmj.25-00042","DOIUrl":"10.3314/mmj.25-00042","url":null,"abstract":"Background: Oral antifungal therapy is the standard treatment for onychomycosis. However, many physicians still prefer topical agents because of concerns about adverse effects.Objectives: This study evaluated changes in hepatic and renal function parameters during fosravuconazole therapy and assessed the utility of an algorithmic approach for interpreting these abnormalities.Methods: Laboratory parameters including aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ glutamyltransferase (γ-GTP), serum creatinine (sCr), and estimated glomerular filtration rate (eGFR) were compared between baseline and follow-up. Fold changes were calculated, and γ-GTP was classified according to the LiverTox database. Each parameter was assessed using an algorithm for managing hepatic and renal side effects.Results: A total of 128 cases were analyzed. Median baseline values were AST 22 U/L, ALT 19 U/L, γ-GTP 25 U/L, sCr 0.75 mg/dL, and eGFR 74.9 mL/min/1.73 m². At follow-up, values were AST 22 U/L, ALT 22 U/L, γ-GTP 51.5 U/L, sCr 0.86 mg/dL, and eGFR 67.1 mL/min/1.73 m². γ-GTP showed significantly greater fold changes than other parameters (p < 0.001). Thresholds for discontinuation were met in 3 hepatic (2.3%) and 5 renal (3.9%) cases. No patient developed clinical symptoms, and only one discontinued treatment.Conclusions: Algorithm-based monitoring enabled safe fosravuconazole administration. This practical approach may help clinicians adopt oral antifungal therapy more confidently as first-line treatment for onychomycosis.","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"67 2","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antifungal Pharmacokinetics/Pharmacodynamics. 抗真菌药物动力学/药效学。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.26.003

Yusuke Yagi, Yukihiro Hamada

{"title":"Antifungal Pharmacokinetics/Pharmacodynamics.","authors":"Yusuke Yagi, Yukihiro Hamada","doi":"10.3314/mmj.26.003","DOIUrl":"10.3314/mmj.26.003","url":null,"abstract":"The optimization of antifungal therapy based on pharmacokinetics/pharmacodynamics (PK/PD) principles is crucial for improving outcomes in invasive fungal infections; however, its clinical application faces considerable hurdles. This review presents a comprehensive overview of current knowledge and aims to bridge basic research and clinical practice. We outline the fundamental concepts of PK/PD and the characteristics of the major antifungal drug classes (polyenes, echinocandins, flucytosines, and azoles), along with preclinical evidence defining the main PK/PD indices (maximum concentration to minimum inhibitory concentration ratio, 24-h area under the concentration-time curve to the minimum inhibitory concentration ratio, and percentage of time the concentration remains above the minimum inhibitory concentration). Key challenges hindering translation are critically analyzed, including substantial knowledge gaps-particularly for filamentous fungi; high inter-patient pharmacokinetic variability complicating standard dosing; limitations of therapeutic drug monitoring (TDM); the narrow therapeutic window requiring careful balance between efficacy and toxicity; and the role of suboptimal exposure in antifungal resistance. Current strategies, including antifungal stewardship, are discussed, and future directions highlighted. Prioritizing research on understudied pathogens, improving TDM, developing novel agents, and strengthening collaboration between basic research and clinical practice are essential. A deeper understanding and effective application of PK/PD principles are vital to advance personalized antifungal therapies and improve patient outcomes.","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"67 1","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing the Minimum Inhibitory Concentrations and Minimum Fungicidal Concentrations of Antifungal Drugs in Microsporum canis. 犬小孢子菌中抗真菌药物最低抑菌浓度与最低杀真菌浓度的比较。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.25-00024

Honoka Nojo, Akira Watanabe, Koichi Makimura, Rui Kano

引用次数: 0

Managing Azole Resistance in Aspergillus. 曲霉抗唑性的控制。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.26.008

Hisako Kushima, Hiroshi Ishii

{"title":"Managing Azole Resistance in Aspergillus.","authors":"Hisako Kushima, Hiroshi Ishii","doi":"10.3314/mmj.26.008","DOIUrl":"10.3314/mmj.26.008","url":null,"abstract":"Azole antifungals are the cornerstone of therapy for aspergillosis, yet the global rise in azole-resistant Aspergillus fumigatus has become a major clinical concern. Resistance rates vary widely across regions, with particularly serious implications for chronic pulmonary aspergillosis (CPA), which requires long-term azole therapy. Resistance mechanisms largely involve cyp51A mutations, although additional genetic alterations and environmental factors, such as agricultural azole use, also play important roles. Cross-resistance among azoles is frequent, leaving clinicians with limited alternatives, such as liposomal amphotericin B or echinocandins, which are constrained by toxicity, fungistatic activity, and intravenous administration. Currently, antifungal susceptibility testing for filamentous fungi remains technically demanding and is not routinely available in many countries, including Japan, further complicating its management. Emerging approaches include the development of novel antifungal compounds and optimization of existing drugs through inhaled or nanoformulated delivery systems. Furthermore, fungal vaccines are attracting increasing attention as promising long-term solutions to stagnant antifungal pipelines and the growing challenge of drug resistance.","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"67 2","pages":"117-123"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticandidal Efficacy of a Paste Containing Capric Acid and a Lysozyme-Chitosan Oligosaccharide Conjugate. 含癸酸和溶菌酶-壳聚糖寡糖缀合物膏体的抗药效果。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.26-00002

Mayu Miyanohara, Hidenori Yamada, Takako Nakatsuka, Masaaki Okamoto, Nobuhiro Hanada, Hiroki Kageshima, Shouichirou Hirano, Takatoshi Murata

引用次数: 0

Development of a Visual Assay Based on Colony Diameter Measurement for Drug Susceptibility Testing of Poorly Sporulating Fungi. 基于菌落直径测定的低孢子真菌药敏检测方法的建立。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.26-00007

Takahito Toyotome, Akira Watanabe, Sayaka Ban, Takashi Yaguchi

{"title":"Development of a Visual Assay Based on Colony Diameter Measurement for Drug Susceptibility Testing of Poorly Sporulating Fungi.","authors":"Takahito Toyotome, Akira Watanabe, Sayaka Ban, Takashi Yaguchi","doi":"10.3314/mmj.26-00007","DOIUrl":"https://doi.org/10.3314/mmj.26-00007","url":null,"abstract":"Antifungal susceptibility testing is essential for guiding the clinical management of fungal infections. However, the standard method for broth dilution testing of filamentous fungi requires spore suspensions and is therefore unsuitable for poorly sporulating fungal species or strains. Some Aspergillus lentulus strains sporulate poorly, and Schizophyllum commune is a clinically relevant non-sporulating fungus for which preparing homogeneous inocula remains challenging. In this study, we developed an agar‑based visual assay to evaluate relative growth inhibition without requiring spores. Using 6‑well plates containing varying concentrations of itraconazole (ITCZ) or voriconazole (VRCZ), the colony diameters of A. lentulus and S. commune were measured after 24 hours and 48 hours, respectively, and normalized to those of the drug‑free control. A. lentulus exhibited clear growth inhibition at 0.25 µg/mL ITCZ, but further increases in concentration did not result in proportionally greater inhibition under the present assay conditions. In contrast, VRCZ markedly and dose‑dependently reduced colony diameter, resulting in only < 10% growth at 4 µg/mL. ITCZ susceptibility varied widely among S. commune strains, whereas VRCZ consistently inhibited growth at concentrations ≥ 1 µg/mL. These susceptibility patterns aligned with previously reported minimum inhibitory concentration ranges for both species. Notably, our method also accommodated slow‑growing strains and allowed extended incubation when necessary. Although not directly comparable to standardized minimum inhibitory concentration methods, our agar‑based assay provides a practical and visually interpretable means to assess drug susceptibility in A. lentulus and S. commune under the tested conditions.","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"67 3","pages":"165-176"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refractory Azole-Resistant Candida albicans Renal and Perirenal Abscess Requiring Nephrectomy. 需要肾切除术的难治性耐唑白色念珠菌肾和肾周脓肿。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.25-00043

Nobuaki Mori, Kana Matsumoto, Ryosuke Shoji, Emiko Mura, Kazuhiko Oshinomi, Yasuyuki Ohira, Masahiro Abe, Ami Koizumi, Masahito Oda, Masayuki Maeda, Keiko Ishino, Issei Tokimatsu

引用次数: 0

In vitro Testing of Trichophyton indotineae Susceptibility to Essential Oil Components Citral and Thymol. 吲哚毛癣菌对精油成分柠檬醛和百里香酚的体外敏感性试验。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.25-00035

Kanon Tsurumi, Sanae A Ishijima, Rui Kano

引用次数: 0

Cutaneous Phaeohyphomycosis Caused by Exophiala jeanselmei. 由jeanselmei外霉引起的皮肤褐丝酵母菌病。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.25-00029

Sayaka Ohara, Hiromitsu Noguchi, Tadahiko Matsumoto, Daiki Hayashi, Kayo Kashiwada-Nakamura, Masahide Kubo, Takashi Yaguchi, Satoshi Fukushima

引用次数: 0

Biofilm and Dermatophytoma. 生物膜与皮肤癣。

Medical mycology journal Pub Date : 2026-01-01 DOI: 10.3314/mmj.26.006

Tomotaka Sato, Norihito Fukada, Hisashi Kobayashi, Aya Okaniwa, Miyuki Okada, Kazuto Yamazaki

引用次数: 0