Invasive aspergillosis

Caspofimgin 50 mg/m /day has been studied in a multicenter, prospective, open study in children aged 3 months to 17 years with invasive aspergillosis, invasive candidiasis, or esophageal candidiasis [88 ]. There were adverse events in seven patients, but none was considered drug related. There were laboratory adverse events in five patients, which were considered to be drug related in three. There were no infusion-related events or withdrawals because of... 

The glucan synthase inhibitor caspofungin (intravenous formulation) is new on the market for the treatment of invasive aspergillosis in patients whose disease is refractory to, or who are intolerant of, other therapies. During the clinical trials fever, infused vein complications, nausea, vomiting and in combination with cyclosporin mild transient hepatic side effects were observed. Interaction with tacrolismius and with potential inducer or mixed inducer/inhibitors of drug clearance was also seen. 

Nodular or halo-like lesions detected by high-resolution computed tomography (HRCT) scans are often the first indication of invasive pulmonary aspergillosis. 

Many experts now consider voriconazole as the initial drug of choice for invasive aspergillosis in patients without significant contraindications (e.g., drug interactions or preexisting liver dysfunction) to azole therapy. 

Invasive molds, particularly Aspergillus, have become an increasingly important complication of cancer therapy and organ transplantation. Patients with acute leukemia and recipients of allogeneic hematopoietic cell transplants are at especially high risk for invasive aspergillosis due to prolonged neutropenia and deficiencies in cell-mediated immunity associated... 

Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002 347 408M15. 

Marr KA, Boeckh M, Carter RA, et al. Combination antifungal therapy for invasive aspergillosis. Clin Infect Dis 2004 39 797-802. Masur H, Kaplan JE, Holmes KK, et al. 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Clin Infect Dis 2000 30 S29-S65. 

Segal BH, Walsh TJ. Current approaches to diagnosis and treatment of invasive aspergillosis. Am J Respir Crit Care Med 2006 173 707-717. 

Carpenter KJ, Hogaboam CM. Immunosuppressive effects of CCL17 on pulmonary antifungal responses during pulmonary invasive aspergillosis. Infect Immun 2005 73(ll) 7198-7207. 

Choi et al.20 FFPE tissues of invasive aspergillosis from 16 pediatric cases, fixed in formalin for 6-72 h To establish an optimal AR protocol for mAb WF-AF-1 (Dako), testing three different retrieval solutions of pH 6.0, 8.0, and 10.0 with MW heating for 10 min Satisfactory IHC results are achieved using AR with high pH. 

In the immunocompromised host, aspergillosis is characterized by vascular invasion leading to thrombosis, infarction, and necrosis of tissue. 

Caspofungin is indicated for treatment of invasive aspergillosis in patients who are refractory to or intolerant of other therapies such as amphotericin B. 

Posaconazole, launched last year in the UK, is the newest member of the azole class of antifungal agents to reach the market. It is indicated for the treatment and prophylaxis of a range of invasive fungal infections, including aspergillosis,... 

Keating G Figgitt D. (2003) Caspofungin Areview of its use in oesophageal candidiasis, invasive candidiasis and invasive aspergillosis. Drugs 63 2235-2263. 

Lipid-based formuiations - For use in patients refractory to conventional amphotericin B deoxycholate therapy or where renal impairment or unacceptable toxicity precludes the use of the deoxycholate formulation for the treatment of invasive fungal infections (lipid complex) for the treatment of invasive aspergillosis (cholesteryl) for the treatment of infections caused by... 

Invasive aspergillosis For the treatment of invasive aspergillosis. In clinical trials, the majority of isolates recovered were Aspergillus fumigatus. There were a small... 

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