Combination antifungal therapy: A strategy for the management of invasive fungal infections

Autores
Carrillo Muñoz, A. J.; Finquelievich, Jorge; Tur Tur, Cristina; Eraso, Elena; Jaureguizar, Nerea; Quindós, Guillermo; Giusiano, Gustavo Emilio
Año de publicación
2014
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
The lack of an ideal antifungal drug or completely successful agent, suggests that combination therapy may be an appropriate option for the management of fungal infections. In this review, different antifungal combination therapy approaches will be discussed. In brief, the rationale for combination therapy is to maximize antifungal effects by attacking different fungal targets at the same time. However, the scientific basis for this approach requires evidence from prospective clinical trials of antifungal combinations. It is possible that real advantages will be seen for particular combinations only in particular mycoses and/or particular types of patient. Combination tends to reduce clinical failure when resistant strains could be recovered from patients, although drug interactions and cross-resistance may result. Synergy has been established between conventional antifungal agents and also between investigational molecules. Alternatively, combination of fluconazole and cyclosporine results fungicidal for fluconazole-susceptible strains of Candida albicans. An overall enhanced susceptibility is reached in intrinsically resistant Candida when combination of azole antifungal drugs or terbinafine with calcineurin inhibitors is used. Azoles, such as voriconazole, itraconazole, and fluconazole are being tested in combination with other antifungal agents such as amphotericin B, caspofungin, or terbinafine and. In addition, amphotericin B is actually administered in combined therapy with caspofungin. The traditional combinations of amphotericin B plus 5-fluorocytosine or amphotericin B plus rifampicin have been replaced by these newer combinations. Other combinations such as caspofungin plus amphotericin B or voriconazole have also been synergic against clinical isolates of Aspergillus and Fusarium. This has been confirmed in animal models in the case of caspofungin plus itraconazole in the treatment of invasive pulmonary aspergillosis and caspofungin plus liposomal amphotericin B in the management of invasive aspergillosis.
Fil: Carrillo Muñoz, A. J.. Departamento de Micología; España
Fil: Finquelievich, Jorge. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Tur Tur, Cristina. Departamento de Micología; España
Fil: Eraso, Elena. Universidad del Pais Vasco; España
Fil: Jaureguizar, Nerea. Universidad del Pais Vasco; España
Fil: Quindós, Guillermo. Universidad del Pais Vasco; España
Fil: Giusiano, Gustavo Emilio. Universidad Nacional del Nordeste. Instituto de Medicina Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
Micosis Invasoras
Tratamiento
Combinaciones
Antifúngicos
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/10301
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/10301
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Combination antifungal therapy: A strategy for the management of invasive fungal infectionsCarrillo Muñoz, A. J.Finquelievich, JorgeTur Tur, CristinaEraso, ElenaJaureguizar, NereaQuindós, GuillermoGiusiano, Gustavo EmilioMicosis InvasorasTratamientoCombinacionesAntifúngicoshttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3The lack of an ideal antifungal drug or completely successful agent, suggests that combination therapy may be an appropriate option for the management of fungal infections. In this review, different antifungal combination therapy approaches will be discussed. In brief, the rationale for combination therapy is to maximize antifungal effects by attacking different fungal targets at the same time. However, the scientific basis for this approach requires evidence from prospective clinical trials of antifungal combinations. It is possible that real advantages will be seen for particular combinations only in particular mycoses and/or particular types of patient. Combination tends to reduce clinical failure when resistant strains could be recovered from patients, although drug interactions and cross-resistance may result. Synergy has been established between conventional antifungal agents and also between investigational molecules. Alternatively, combination of fluconazole and cyclosporine results fungicidal for fluconazole-susceptible strains of Candida albicans. An overall enhanced susceptibility is reached in intrinsically resistant Candida when combination of azole antifungal drugs or terbinafine with calcineurin inhibitors is used. Azoles, such as voriconazole, itraconazole, and fluconazole are being tested in combination with other antifungal agents such as amphotericin B, caspofungin, or terbinafine and. In addition, amphotericin B is actually administered in combined therapy with caspofungin. The traditional combinations of amphotericin B plus 5-fluorocytosine or amphotericin B plus rifampicin have been replaced by these newer combinations. Other combinations such as caspofungin plus amphotericin B or voriconazole have also been synergic against clinical isolates of Aspergillus and Fusarium. This has been confirmed in animal models in the case of caspofungin plus itraconazole in the treatment of invasive pulmonary aspergillosis and caspofungin plus liposomal amphotericin B in the management of invasive aspergillosis.Fil: Carrillo Muñoz, A. J.. Departamento de Micología; EspañaFil: Finquelievich, Jorge. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Tur Tur, Cristina. Departamento de Micología; EspañaFil: Eraso, Elena. Universidad del Pais Vasco; EspañaFil: Jaureguizar, Nerea. Universidad del Pais Vasco; EspañaFil: Quindós, Guillermo. Universidad del Pais Vasco; EspañaFil: Giusiano, Gustavo Emilio. Universidad Nacional del Nordeste. Instituto de Medicina Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaGrupo Ars Xxi Comunicacion S L2014-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/10301Carrillo Muñoz, A. J.; Finquelievich, Jorge; Tur Tur, Cristina; Eraso, Elena; Jaureguizar, Nerea; et al.; Combination antifungal therapy: A strategy for the management of invasive fungal infections; Grupo Ars Xxi Comunicacion S L; Revista Espanola de Quimioterapia; 27; 3; 9-2014; 141-1580214-3429enginfo:eu-repo/semantics/altIdentifier/url/http://seq.es/seq/0214-3429/27/3/carrillo.pdfinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:38:36Zoai:ri.conicet.gov.ar:11336/10301instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:38:37.083CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Combination antifungal therapy: A strategy for the management of invasive fungal infections
title Combination antifungal therapy: A strategy for the management of invasive fungal infections
spellingShingle Combination antifungal therapy: A strategy for the management of invasive fungal infections
Carrillo Muñoz, A. J.
Micosis Invasoras
Tratamiento
Combinaciones
Antifúngicos
title_short Combination antifungal therapy: A strategy for the management of invasive fungal infections
title_full Combination antifungal therapy: A strategy for the management of invasive fungal infections
title_fullStr Combination antifungal therapy: A strategy for the management of invasive fungal infections
title_full_unstemmed Combination antifungal therapy: A strategy for the management of invasive fungal infections
title_sort Combination antifungal therapy: A strategy for the management of invasive fungal infections
dc.creator.none.fl_str_mv Carrillo Muñoz, A. J.
Finquelievich, Jorge
Tur Tur, Cristina
Eraso, Elena
Jaureguizar, Nerea
Quindós, Guillermo
Giusiano, Gustavo Emilio
author Carrillo Muñoz, A. J.
author_facet Carrillo Muñoz, A. J.
Finquelievich, Jorge
Tur Tur, Cristina
Eraso, Elena
Jaureguizar, Nerea
Quindós, Guillermo
Giusiano, Gustavo Emilio
author_role author
author2 Finquelievich, Jorge
Tur Tur, Cristina
Eraso, Elena
Jaureguizar, Nerea
Quindós, Guillermo
Giusiano, Gustavo Emilio
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Micosis Invasoras
Tratamiento
Combinaciones
Antifúngicos
topic Micosis Invasoras
Tratamiento
Combinaciones
Antifúngicos
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv The lack of an ideal antifungal drug or completely successful agent, suggests that combination therapy may be an appropriate option for the management of fungal infections. In this review, different antifungal combination therapy approaches will be discussed. In brief, the rationale for combination therapy is to maximize antifungal effects by attacking different fungal targets at the same time. However, the scientific basis for this approach requires evidence from prospective clinical trials of antifungal combinations. It is possible that real advantages will be seen for particular combinations only in particular mycoses and/or particular types of patient. Combination tends to reduce clinical failure when resistant strains could be recovered from patients, although drug interactions and cross-resistance may result. Synergy has been established between conventional antifungal agents and also between investigational molecules. Alternatively, combination of fluconazole and cyclosporine results fungicidal for fluconazole-susceptible strains of Candida albicans. An overall enhanced susceptibility is reached in intrinsically resistant Candida when combination of azole antifungal drugs or terbinafine with calcineurin inhibitors is used. Azoles, such as voriconazole, itraconazole, and fluconazole are being tested in combination with other antifungal agents such as amphotericin B, caspofungin, or terbinafine and. In addition, amphotericin B is actually administered in combined therapy with caspofungin. The traditional combinations of amphotericin B plus 5-fluorocytosine or amphotericin B plus rifampicin have been replaced by these newer combinations. Other combinations such as caspofungin plus amphotericin B or voriconazole have also been synergic against clinical isolates of Aspergillus and Fusarium. This has been confirmed in animal models in the case of caspofungin plus itraconazole in the treatment of invasive pulmonary aspergillosis and caspofungin plus liposomal amphotericin B in the management of invasive aspergillosis.
Fil: Carrillo Muñoz, A. J.. Departamento de Micología; España
Fil: Finquelievich, Jorge. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Tur Tur, Cristina. Departamento de Micología; España
Fil: Eraso, Elena. Universidad del Pais Vasco; España
Fil: Jaureguizar, Nerea. Universidad del Pais Vasco; España
Fil: Quindós, Guillermo. Universidad del Pais Vasco; España
Fil: Giusiano, Gustavo Emilio. Universidad Nacional del Nordeste. Instituto de Medicina Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description The lack of an ideal antifungal drug or completely successful agent, suggests that combination therapy may be an appropriate option for the management of fungal infections. In this review, different antifungal combination therapy approaches will be discussed. In brief, the rationale for combination therapy is to maximize antifungal effects by attacking different fungal targets at the same time. However, the scientific basis for this approach requires evidence from prospective clinical trials of antifungal combinations. It is possible that real advantages will be seen for particular combinations only in particular mycoses and/or particular types of patient. Combination tends to reduce clinical failure when resistant strains could be recovered from patients, although drug interactions and cross-resistance may result. Synergy has been established between conventional antifungal agents and also between investigational molecules. Alternatively, combination of fluconazole and cyclosporine results fungicidal for fluconazole-susceptible strains of Candida albicans. An overall enhanced susceptibility is reached in intrinsically resistant Candida when combination of azole antifungal drugs or terbinafine with calcineurin inhibitors is used. Azoles, such as voriconazole, itraconazole, and fluconazole are being tested in combination with other antifungal agents such as amphotericin B, caspofungin, or terbinafine and. In addition, amphotericin B is actually administered in combined therapy with caspofungin. The traditional combinations of amphotericin B plus 5-fluorocytosine or amphotericin B plus rifampicin have been replaced by these newer combinations. Other combinations such as caspofungin plus amphotericin B or voriconazole have also been synergic against clinical isolates of Aspergillus and Fusarium. This has been confirmed in animal models in the case of caspofungin plus itraconazole in the treatment of invasive pulmonary aspergillosis and caspofungin plus liposomal amphotericin B in the management of invasive aspergillosis.
publishDate 2014
dc.date.none.fl_str_mv 2014-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/10301
Carrillo Muñoz, A. J.; Finquelievich, Jorge; Tur Tur, Cristina; Eraso, Elena; Jaureguizar, Nerea; et al.; Combination antifungal therapy: A strategy for the management of invasive fungal infections; Grupo Ars Xxi Comunicacion S L; Revista Espanola de Quimioterapia; 27; 3; 9-2014; 141-158
0214-3429
url http://hdl.handle.net/11336/10301
identifier_str_mv Carrillo Muñoz, A. J.; Finquelievich, Jorge; Tur Tur, Cristina; Eraso, Elena; Jaureguizar, Nerea; et al.; Combination antifungal therapy: A strategy for the management of invasive fungal infections; Grupo Ars Xxi Comunicacion S L; Revista Espanola de Quimioterapia; 27; 3; 9-2014; 141-158
0214-3429
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://seq.es/seq/0214-3429/27/3/carrillo.pdf
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Grupo Ars Xxi Comunicacion S L
publisher.none.fl_str_mv Grupo Ars Xxi Comunicacion S L
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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