The DOI matches its Crossref record; 412 of the 412 references it cites were found in a registry or an index.
Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients
Open accessAbstract
INTRODUCTION: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety. MATERIALS AND METHODS: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy. CONCLUSIONS AND DISCUSSION: Amphotericin B is eliminated unchanged via urine and faeces. Flucytosine and fluconazole display low protein binding and are eliminated by the kidney. Itraconazole, voriconazole, posaconazole and isavuconazole are metabolised in the liver. Azoles are substrates and inhibitors of cytochrome P450 (CYP) isoenzymes and are therefore involved in numerous drug-drug interactions. Anidulafungin is spontaneously degraded in the plasma. Caspofungin and micafungin undergo enzymatic metabolism in the liver, which is independent of CYP. Although several drug-drug interactions occur during caspofungin and micafungin treatment, echinocandins display a lower potential for drug-drug interactions. Flucytosine and azoles penetrate into most of relevant tissues. Amphotericin B accumulates in the liver and in the spleen. Its concentrations in lung and kidney are intermediate and relatively low myocardium and brain. Tissue distribution of echinocandins is similar to that of amphotericin. Combination antifungal therapy is established for cryptococcosis but controversial in other IFIs such as invasive aspergillosis and mucormycosis.
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Voriconazole versus Amphotericin B for Primary Therapy of Invasive Aspergillosis
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Synergy, antagonism, and what the chequerboard puts between them
Odds, F. C. (2003) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkg301 · Cited by 2,481
Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
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Cited by
Shafiei, M., Peyton, L., Hashemzadeh, M., & Foroumadi, A. (2020) · Bioorganic Chemistry · doi:10.1016/j.bioorg.2020.104240 · Cited by 295
Invasive candidiasis in critical care: challenges and future directions
Logan, C., Martin-Loeches, I., & Bicanic, T. (2020) · Intensive Care Medicine · doi:10.1007/s00134-020-06240-x · Cited by 180
Biofilm formation in medically important Candida species
Malinovská, Z., Čonková, E., & Váczi, P. (2023) · Journal of Fungi · doi:10.3390/jof9100955 · Cited by 167
Candida auris Genetics and Emergence
Chowdhary, A., Jain, K., & Chauhan, N. (2023) · Annual Review of Microbiology · doi:10.1146/annurev-micro-032521-015858 · Cited by 158
Antifungal Drugs TDM: Trends and Update
Kably, B., Launay, M., Derobertmasure, A., Lefeuvre, S., Dannaoui, E., & Billaud, E. M. (2022) · Therapeutic Drug Monitoring · doi:10.1097/ftd.0000000000000952 · Cited by 81
Metadata
- Authors
- Bellmann, R., & Smuszkiewicz, P.
- Venue
- Infection
- Published
- 2017-07-12
- Volume
- 45
- Issue
- 6
- Pages
- 737-779
- ISSN
- 0300-8126 (ISSN-L)
- 1439-0973
- OpenAlex
- W2736147055
- Cited by
- 389
- References
- 412
- FWCI
- 15.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
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