کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2120345 1085681 2014 14 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The role of azoles in the management of azole-resistant aspergillosis: From the bench to the bedside
ترجمه فارسی عنوان
نقش آئول ها در مدیریت آسپرژیلوز مقاوم به آئول: از نیمکت تا بالشتک
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی تحقیقات سرطان
چکیده انگلیسی

Azole resistance is an emerging problem in Aspergillus fumigatus and is associated with a high probability of treatment failure. An azole resistance mechanism typically decreases the activity of multiple azole compounds, depending on the mutation. As alternative treatment options are limited and in some isolates the minimum inhibitory concentration (MIC) increases by only a few two-fold dilutions steps, we investigated if voriconazole and posaconazole have a role in treating azole-resistant Aspergillus disease. The relation between resistance genotype and phenotype, pharmacokinetic and pharmacodynamic properties, and (pre)clinical treatment efficacy were reviewed. The results were used to estimate the exposure needed to achieve the pharmacodynamic target for each MIC. For posaconazole adequate exposure can be achieved only for wild type isolates as dose escalation does not allow PD target attainment. However, the new intravenous formulation might result in sufficient exposure to treat isolates with a MIC of 0.5 mg/L. For voriconazole our analysis indicated that the exposure needed to treat infection due to isolates with a MIC of 2 mg/L is feasible and maybe isolates with a MIC of 4 mg/L. However, extreme caution and strict monitoring of drug levels would be required, as the probability of toxicity will also increase.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Drug Resistance Updates - Volume 17, Issue 3, July 2014, Pages 37–50
نویسندگان
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