Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?

Current Fungal Infection Reports
Alison R NovakScott W Mueller

Abstract

This review summarizes current treatment options for echinocandin-resistant Candida spp. (ERC) and azole-resistant Aspergillus fumigatus (ARAF), emphasizing recent in vitro/in vivo data, clinical reports, and consensus statements. Advances in ERC and ARAF treatment are limited to specific antifungal combinations and dose optimization but remain reliant on amphotericin products. Although novel antifungals may provide breakthroughs in the treatment of resistant fungi, these agents are not yet available. Early identification and appropriate treatment remain a paramount, albeit elusive, task. When either ERC or ARAF are suspected or proven, amphotericin products remain the cornerstone of initial therapy. For ERC, azoles are de-escalation options for susceptible isolates in stable patients to avoid amphotericin toxicities. Although combination echinocandin with high-dose salvage posaconazole or isavuconazole may be attempted in ARAF, it requires careful consideration following patient stabilization. Future research defining optimal therapies and early identification of ERC and ARAF is of extreme importance.

References

Jun 1, 1997·Antimicrobial Agents and Chemotherapy·D W DenningS L Kelly
Feb 27, 2003·Antimicrobial Agents and Chemotherapy·T M Diaz-GuerraJ L Rodriguez-Tudela
Apr 24, 2003·Antimicrobial Agents and Chemotherapy·Adriana M NascimentoDavid S Perlin
Oct 13, 2006·International Journal of Antimicrobial Agents·Susan J HowardDavid W Denning
Sep 17, 2008·Antimicrobial Agents and Chemotherapy·Paul E VerweijJohan W Mouton
Mar 11, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jan W M van der LindenPaul E Verweij
Oct 21, 2009·The Journal of Antimicrobial Chemotherapy·C ViscoliUNKNOWN Infectious Disease Group of the EORTC
Aug 2, 2011·Mayo Clinic Proceedings·Russell E Lewis
Sep 14, 2011·Antimicrobial Agents and Chemotherapy·O A CornelyA H Groll
Oct 18, 2011·Emerging Infectious Diseases·Jan W M van der LindenPaul E Verweij
Nov 7, 2012·The Journal of Antimicrobial Chemotherapy·Seyedmojtaba SeyedmousaviJohan W Mouton
Mar 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Barbara D AlexanderMichael A Pfaller
Jun 4, 2014·Antimicrobial Agents and Chemotherapy·Cau D PhamShawn R Lockhart
Jul 2, 2014·Antimicrobial Agents and Chemotherapy·Janet F StaabKieren A Marr
Aug 26, 2014·Emerging Infectious Diseases·Cau D PhamShawn R Lockhart
Jan 20, 2015·Annals of Internal Medicine·Kieren A MarrJohan A Maertens
Apr 24, 2015·Journal of Clinical Microbiology·Jakko van IngenPaul E Verweij
May 20, 2015·Emerging Infectious Diseases·J W M van der LindenP E Verweij
Jun 3, 2015·Mycoses·Maurizio SanguinettiCornelia Lass-Flörl
Jun 30, 2015·Current Clinical Microbiology Reports·David S PerlinYanan Zhao
Aug 19, 2015·Drug Resistance Updates : Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy·Paul E VerweijJ Peter Donnelly
Oct 22, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul E VerweijJacques F Meis
Nov 15, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David S Perlin
Dec 19, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Peter G PappasJack D Sobel
Jul 2, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas F PattersonJohn E Bennett
Nov 23, 2016·Antimicrobial Agents and Chemotherapy·María Ángeles Bordallo-CardonaJesús Guinea
Dec 27, 2016·Frontiers in Microbiology·Kelley R HealeyDavid S Perlin
Mar 30, 2017·The Journal of Antimicrobial Chemotherapy·Katharine E Stott, William W Hope
May 12, 2017·Mycopathologia·Laura Bedin DenardiSydney Hartz Alves
Aug 30, 2017·Antimicrobial Agents and Chemotherapy·Hamed FakhimHamid Badali
Sep 16, 2017·The Journal of Infectious Diseases·Maiken Cavling Arendrup, Thomas F Patterson
Sep 16, 2017·The Journal of Infectious Diseases·Anuradha ChowdharyJacques F Meis
Oct 4, 2017·Antimicrobial Agents and Chemotherapy·Anne-Hortense Schmitt-HoffmannMarlowe J Schneidkraut

❮ Previous
Next ❯

Citations

Apr 22, 2021·Expert Opinion on Pharmacotherapy·Scott W MuellerKyle C Molina

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aspergillosis (ASM)

Aspergillosis is the name given to a wide variety of diseases caused by infection by fungi of the genus Aspergillus. Aspergillosis occurs in chronic or acute forms which are clinically very distinct. Most cases of acute aspergillosis occur in patients with severely compromised immune systems. Chronic colonization or infection can cause complications in people with underlying respiratory illnesses. Discover the latest research on aspergillosis here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Aspergillosis

Aspergillosis is the name given to a wide variety of diseases caused by infection by fungi of the genus Aspergillus. Aspergillosis occurs in chronic or acute forms which are clinically very distinct. Most cases of acute aspergillosis occur in patients with severely compromised immune systems. Chronic colonization or infection can cause complications in people with underlying respiratory illnesses. Discover the latest research on aspergillosis here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.