重新评估抗真菌联合疗法在当今时代的作用。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES
Chin Fen Neoh,Monica A Slavin
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引用次数: 0

摘要

综述目的鉴于侵袭性真菌病(IFDs)的死亡率和发病率较高,尽管数据匮乏,但人们仍经常考虑使用联合抗真菌疗法。本综述旨在总结抗真菌联合疗法的文献现状,讨论较新的抗真菌联合疗法的潜在作用及其临床应用的主要注意事项。在隐球菌脑膜炎以外的感染中,或在对疑似耐唑曲霉菌感染进行经验性治疗时,由于设计良好的随机对照试验较少,抗真菌联合疗法的效用仍存在争议。有关潜在联合抗真菌疗法的数据主要局限于体外研究、动物模型、病例报告和/或观察性研究。随着新型抗真菌药物(如 ibrexafungerp、fosmanogepix)的问世,治疗霉菌感染的联合疗法应被重新审视。目前正在进行一项伊布沙芬格普联合伏立康唑治疗侵袭性肺曲霉菌病的 2 期临床试验。总结:有必要对联合抗真菌药物的使用进行研究,其中包括明确这些联合抗真菌疗法的适应症,并确定如何在临床环境中最恰当地使用这些药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reassessment of the role of combination antifungal therapy in the current era.
PURPOSE OF REVIEW Given the high mortality and morbidity associated with invasive fungal diseases (IFDs), the use of combination antifungal therapies is often considered despite the dearth of data. This review aims to summarize the current state of literature of combination antifungal therapies, discussing the potential roles of newer antifungal combinations and key considerations for their clinical use. RECENT FINDINGS In infections other than cryptococcal meningitis or in the setting of empirical treatment for suspected azole-resistant Aspergillus infections, the utility of the combination antifungal approaches remains controversial given the paucity of well designed randomized controlled trials. Data on potential combined antifungal treatments have been primarily limited to in-vitro studies, animal models, case reports and/or observational studies. With availability of novel antifungal agents (e.g. ibrexafungerp, fosmanogepix), combination therapy to treat mould infections should be re-visited. A phase 2 clinical trial of ibrexafungerp combined with voriconazole to treat invasive pulmonary aspergillosis is on-going. SUMMARY There is a need to investigate the use of combination antifungal agents. This includes delineating the indication of these combined antifungal therapies and determining how to use them most appropriately in the clinical setting.
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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