Voriconazole
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012402 Voriconazole Compared with Liposomal Amphotericin B
The New England Journal of Medicine Copyright © 2002 by the Massachusetts Medical Society VOLUME 346 J ANUARY 24, 2002 NUMBER 4 VORICONAZOLE COMPARED WITH LIPOSOMAL AMPHOTERICIN B FOR EMPIRICAL ANTIFUNGAL THERAPY IN PATIENTS WITH NEUTROPENIA AND PERSISTENT FEVER THOMAS J. WALSH, M.D., PETER PAPPAS, M.D., DREW J. WINSTON, M.D., HILLARD M. LAZARUS, M.D., FINN PETERSEN, M.D., JOHN RAFFALLI, M.D., SAUL YANOVICH, M.D., PATRICK STIFF, M.D., RICHARD GREENBERG, M.D., GERALD DONOWITZ, M.D., AND JEANETTE LEE, PH.D., FOR THE NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES MYCOSES STUDY GROUP* ABSTRACT NVASIVE fungal infections are important caus- Background Patients with neutropenia and per- es of morbidity and mortality among patients sistent fever are often treated empirically with am- receiving cancer chemotherapy or undergoing photericin B or liposomal amphotericin B to prevent bone marrow or stem-cell transplantation.1-3 invasive fungal infections. Antifungal triazoles offer IOver the past two decades, empirical antifungal ther- a potentially safer and effective alternative. apy with conventional amphotericin B or liposomal Methods In a randomized, international, multi- amphotericin B has become the standard of care in center trial, we compared voriconazole, a new sec- reducing invasive fungal infections in patients with ond-generation triazole, with liposomal amphoteri- neutropenia and persistent fever.4-9 Amphotericin B, cin B for empirical antifungal therapy. however, is associated with significant dose-limiting Results A total of -
Susceptibility of Filamentous Fungi to Voriconazole in Malaysia Tested by Sensititre Yeastone and CLSI Microdilution Methods
Susceptibility of Filamentous Fungi to Voriconazole in Malaysia Tested by Sensititre YeastOne and CLSI Microdilution Methods Xue Ting Tan ( [email protected] ) National Institute of Health, Malaysia Stephanie Jane Ginsapu National Institute of Health, Malaysia Fairuz binti Amran National Institute of Health, Malaysia Salina binti Mohamed Sukur National Institute of Health, Malaysia Surianti binti Shukor National Institute of Health, Malaysia Research Article Keywords: Voriconazole, Sensititre, CLSI, Mould Posted Date: February 12th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-199013/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/15 Abstract Background: Voriconazole is a trizaole antifungal to treat fungal infection. In this study, the susceptibility pattern of voriconazole against lamentous fungi was studied using Sensititre® YeastOne and Clinical & Laboratory Standards Institute (CLSI) M38 broth microdilution method. Methods: The suspected cultures of Aspergillus niger, A. avus, A. fumigatus, A. versicolor, A. sydowii, A. calidoutus, A. creber, A. ochraceopetaliformis, A. tamarii, Fusarium solani, F. longipes, F. falciferus, F. keratoplasticum, Rhizopus oryzae, R. delemar, R. arrhizus, Mucor sp., Poitrasia circinans, Syncephalastrum racemosum and Sporothrix schenckii were received from hospitals. Their identication had been conrmed in our lab and susceptibility tests were performed using Sensititre® YeastOne and CLSI M38 broth microdilution method. The signicant differences between two methods were calculated using Wilcoxon Sign Rank test. Results: Mean of the minimum inhibitory concentrations (MIC) for Aspergillus spp. and Fusarium were within 0.25 μg/mL-2.00 μg/mL by two methods except A. calidoutus, F. solani and F. keratoplasticum. -
Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut
■ CLINICAL REVIEW Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut Tinea versicolor (pityriasis versicolor) is a common imidazole, has been used for years both orally and top superficial fungal infection of the stratum corneum. ically with great success, although it has not been Caused by the fungus Malassezia furfur, this chronical approved by the Food and Drug Administration for the ly recurring disease is most prevalent in the tropics but indication of tinea versicolor. Newer derivatives, such is also common in temperate climates. Treatments are as fluconazole and itraconazole, have recently been available and cure rates are high, although recurrences introduced. Side effects associated with these triazoles are common. Traditional topical agents such as seleni tend to be minor and low in incidence. Except for keto um sulfide are effective, but recurrence following treat conazole, oral antifungals carry a low risk of hepato- ment with these agents is likely and often rapid. toxicity. Currently, therapeutic interest is focused on synthetic Key Words: Tinea versicolor; pityriasis versicolor; anti “-azole” antifungal drugs, which interfere with the sterol fungal agents. metabolism of the infectious agent. Ketoconazole, an (J Fam Pract 1996; 43:127-132) ormal skin flora includes two morpho than formerly thought. In one study, children under logically discrete lipophilic yeasts: a age 14 represented nearly 5% of confirmed cases spherical form, Pityrosporum orbicu- of the disease.3 In many of these cases, the face lare, and an ovoid form, Pityrosporum was involved, a rare manifestation of the disease in ovale. Whether these are separate enti adults.1 The condition is most prevalent in tropical tiesN or different morphologic forms in the cell and semitropical areas, where up to 40% of some cycle of the same organism remains unclear.: In the populations are affected. -
Itraconazole (Sporonox ) & Voriconazole (Vfend )
Itraconazole (Sporonox) & Voriconazole (Vfend) These are broad spectrum, anti-fungal agents that can be taken orally. They are very expensive approx $800- $1100/month). Although both these prescription medications are FDA approved for the treatment of mold or fungal infections, they do not have a specific indication for the treatment of fungal rhinosinusitis. Molds appear to be present in everyone's nasal and sinus passageways but in some individuals, the molds appear to cause disease. The explanation for this is unknown (See What is Rhinosinusitis?). As such, Insurers resist covering them for treatment of rhinosinusitis associated with the presence of molds. Itraconazole • Your liver enzymes will be monitored by periodically by blood tests. • Take your Itraconazole dose at the same time everyday. • Take your medication after a full meal. • Antacids can reduce absorption of this medication and if need be they should be taken at least 1 hour before or 2 hours after taking Itraconazole. • If you are taking stomach medication, make sure you drink cola beverage with the Itraconazole to help it become absorbed. • Report any signs or symptoms of unusual fatigue, anorexia, nausea and/or vomiting, jaundice (yellowing skin), dark urine, or pale stools. • Other potential side effects include elevated liver enzymes, gastrointestinal disorders, rash, hypertension, orthostatic hypertension, headache, malaise, myalgia, vasculitis, edema, and vertigo. • Contact your practitioner BEFORE beginning any new medications while taking Itraconazole. • Women should use effective measures to PREVENT pregnancy during and up to 2 months after finishing itraconazole. • Itraconazole should not be taken with a class of cholesterol-lowering drugs known as statins, unless your physicians has specifically told you to do so. -
Stability of Two Antifungal Agents, Fluconazole and Miconazole, Compounded in HUMCO RECURA Topical Cream to Determine Beyond-Use Date
PEER REVIEWED Stability of Two Antifungal Agents, Fluconazole and Miconazole, Compounded in HUMCO RECURA Topical Cream to Determine Beyond-use Date ABSTRACT Pradeep Gautam, MS Chemistry A novel compounding vehicle (RECURA) has previously been proven to Bob Light, BS, RPh penetrate the nail bed when compounded with the antifungal agent miconazole or fluconazole, providing for an effective treatment for onychomycosis. In this Troy Purvis, PhD study, miconazole and fluconazole were compounded separately in RECURA compounding cream, and they were tested at different time points (0, 7, 14, 28, 45, 60, 90, and 180 days), determining the beyond-use date of those INTRODUCTION formulations. The beyond-use date testing of both formulations (10% Onychomycosis is a fungal infection of miconazole in RECURA and 10% fluconazole in RECURA) proved them to be the nail bed in the fingers, or more com- physically, chemically, and microbiologically stable under International monly the toes, which affects an estimated Conference of Harmonisation controlled room temperature (25°C ± 2°C/60% 1 10% of the world’s population. Trichophy- RH ±5%) for at least 180 days from the date of compounding. Stability- ton is the typical fungal genus that causes indicating analytical method validation was completed for the simultaneous these infections in Western countries, while determination of miconazole and fluconazole in RECURA base using high- those living tropical regions experience Candida, Aspergillus, or Scytaldium infec- performance liquid chromatography coupled with photodiode array detector tion,2 but the symptoms of these infections prior to the study. are similar across the board. Minor infec- tion causes a yellow or black thickening of the nail bed, while further progression can 48% cure rate),1 yet concern about long- These medications must be in direct contact result in the nail chipping away and leaving term dosing and severe side-effects due to with the fungus in order to kill it.5 The FDA- an open sore, leading to secondary infec- oral administration exists. -
The Epidemiology and Clinical Features of Balamuthia Mandrillaris Disease in the United States, 1974 – 2016
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Clin Infect Manuscript Author Dis. Author manuscript; Manuscript Author available in PMC 2020 August 28. Published in final edited form as: Clin Infect Dis. 2019 May 17; 68(11): 1815–1822. doi:10.1093/cid/ciy813. The Epidemiology and Clinical Features of Balamuthia mandrillaris Disease in the United States, 1974 – 2016 Jennifer R. Cope1, Janet Landa1,2, Hannah Nethercut1,3, Sarah A. Collier1, Carol Glaser4, Melanie Moser5, Raghuveer Puttagunta1, Jonathan S. Yoder1, Ibne K. Ali1, Sharon L. Roy6 1Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA 2James A. Ferguson Emerging Infectious Diseases Fellowship Program, Baltimore, MD, USA 3Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA 4Kaiser Permanente, San Francisco, CA, USA 5Office of Financial Resources, Centers for Disease Control and Prevention Atlanta, GA, USA 6Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA Abstract Background—Balamuthia mandrillaris is a free-living ameba that causes rare, nearly always fatal disease in humans and animals worldwide. B. mandrillaris has been isolated from soil, dust, and water. Initial entry of Balamuthia into the body is likely via the skin or lungs. To date, only individual case reports and small case series have been published. Methods—The Centers for Disease Control and Prevention (CDC) maintains a free-living ameba (FLA) registry and laboratory. To be entered into the registry, a Balamuthia case must be laboratory-confirmed. -
DIFLUCAN® (Fluconazole Tablets) (Fluconazole for Oral Suspension)
® DIFLUCAN (Fluconazole Tablets) (Fluconazole for Oral Suspension) DESCRIPTION DIFLUCAN® (fluconazole), the first of a new subclass of synthetic triazole antifungal agents, is available as tablets for oral administration, as a powder for oral suspension. Fluconazole is designated chemically as 2,4-difluoro-α,α1-bis(1H-1,2,4-triazol-1-ylmethyl) benzyl alcohol with an empirical formula of C13H12F2N6O and molecular weight of 306.3. The structural formula is: OH N N N N CH2 C CH2 N F N F Fluconazole is a white crystalline solid which is slightly soluble in water and saline. DIFLUCAN Tablets contain 50 mg, 100 mg, 150 mg, or 200 mg of fluconazole and the following inactive ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, povidone, croscarmellose sodium, FD&C Red No. 40 aluminum lake dye, and magnesium stearate. DIFLUCAN for Oral Suspension contains 350 mg or 1400 mg of fluconazole and the following inactive ingredients: sucrose, sodium citrate dihydrate, citric acid anhydrous, sodium benzoate, titanium dioxide, colloidal silicon dioxide, xanthan gum, and natural orange flavor. After reconstitution with 24 mL of distilled water or Purified Water (USP), each mL of reconstituted suspension contains 10 mg or 40 mg of fluconazole. CLINICAL PHARMACOLOGY Pharmacokinetics and Metabolism The pharmacokinetic properties of fluconazole are similar following administration by the intravenous or oral routes. In normal volunteers, the bioavailability of orally administered fluconazole is over 90% compared with intravenous administration. Bioequivalence was Reference ID: 4387685 established between the 100 mg tablet and both suspension strengths when administered as a single 200 mg dose. Peak plasma concentrations (Cmax) in fasted normal volunteers occur between 1 and 2 hours with a terminal plasma elimination half-life of approximately 30 hours (range: 20 to 50 hours) after oral administration. -
Treatment of Visceral Leishmaniasis with Intravenous Pentamidine And
International Journal of Infectious Diseases 14 (2010) e522–e525 Contents lists available at ScienceDirect International Journal of Infectious Diseases journal homepage: www.elsevier.com/locate/ijid Case Report Treatment of visceral leishmaniasis with intravenous pentamidine and oral fluconazole in an HIV-positive patient with chronic renal failure — a case report and brief review of the literature Jan Rybniker a, Valentin Goede a, Jessica Mertens b, Monika Ortmann c, Wolfgang Kulas d, Matthias Kochanek a, Thomas Benzing e, Jose´ R. Arribas f, Gerd Fa¨tkenheuer a,* a 1st Department of Internal Medicine, University of Cologne, 50924 Cologne, Germany b Department of Gastroenterology, University of Cologne, Cologne, Germany c Institute of Pathology, University of Cologne, Cologne, Germany d Nephrologisches Zentrum Mettmann, Mettmann, Germany e Department of Medicine and Centre for Molecular Medicine, University of Cologne, Cologne, Germany f Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain ARTICLE INFO SUMMARY Article history: We report the case of an HIV-positive patient with visceral leishmaniasis and several relapses after Received 3 March 2009 treatment with the two first-line anti-leishmanial drugs, liposomal amphotericin B and miltefosine. End- Accepted 4 June 2009 stage renal failure occurred in 2007 when the patient was on long-term treatment with miltefosine. A Corresponding Editor: William Cameron, relapse of leishmaniasis in 2008 was successfully treated with a novel combination regimen of Ottawa, Canada intravenous pentamidine and oral fluconazole. Secondary prophylaxis with fluconazole monotherapy did not prevent parasitological relapse of leishmaniasis. Keywords: ß 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. Visceral leishmaniasis HIV Fluconazole Pentamidine Miltefosine Renal failure 1. -
Estonian Statistics on Medicines 2016 1/41
Estonian Statistics on Medicines 2016 ATC code ATC group / Active substance (rout of admin.) Quantity sold Unit DDD Unit DDD/1000/ day A ALIMENTARY TRACT AND METABOLISM 167,8985 A01 STOMATOLOGICAL PREPARATIONS 0,0738 A01A STOMATOLOGICAL PREPARATIONS 0,0738 A01AB Antiinfectives and antiseptics for local oral treatment 0,0738 A01AB09 Miconazole (O) 7088 g 0,2 g 0,0738 A01AB12 Hexetidine (O) 1951200 ml A01AB81 Neomycin+ Benzocaine (dental) 30200 pieces A01AB82 Demeclocycline+ Triamcinolone (dental) 680 g A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+ Thymol (dental) 3094 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+ Cetylpyridinium chloride (gingival) 227150 g A01AD81 Lidocaine+ Cetrimide (O) 30900 g A01AD82 Choline salicylate (O) 864720 pieces A01AD83 Lidocaine+ Chamomille extract (O) 370080 g A01AD90 Lidocaine+ Paraformaldehyde (dental) 405 g A02 DRUGS FOR ACID RELATED DISORDERS 47,1312 A02A ANTACIDS 1,0133 Combinations and complexes of aluminium, calcium and A02AD 1,0133 magnesium compounds A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 811120 pieces 10 pieces 0,1689 A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 3101974 ml 50 ml 0,1292 A02AD83 Calcium carbonate+ Magnesium carbonate (O) 3434232 pieces 10 pieces 0,7152 DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 46,1179 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 2,3855 A02BA02 Ranitidine (O) 340327,5 g 0,3 g 2,3624 A02BA02 Ranitidine (P) 3318,25 g 0,3 g 0,0230 A02BC Proton pump inhibitors 43,7324 A02BC01 Omeprazole -
Cutaneous Sporotrichosis of Face: Polymorphism and Reactivation After Intralesional Triamcinolone
Case Report CCutaneousutaneous sporotrichosissporotrichosis ofof face:face: PolymorphismPolymorphism andand reactivationreactivation afterafter iintralesionalntralesional triamcinolonetriamcinolone NNandand LLalal Sharma,Sharma, KKaranaran InderInder SSinghingh MMehta,ehta, VVikramikram K.K. MMahajan,ahajan, AAnilnil KK.. KKanga*,anga*, VVikasikas CChanderhander SSharma,harma, GitaGita RR.. TTegtaegta Departments of Dermatology, Venereology and Leprosy and *Microbiology, Indira Gandhi Medical College, Shimla, India. Address for correspondence: Dr. N. L. Sharma, Department of Dermatology, Venereology and Leprosy, Indira Gandhi Medical College, Shimla - 171001 (H. P.), India. E-mail: [email protected] ABSTRACT Cutaneous sporotrichosis, a subcutaneous mycotic infection is caused by the saprophytic, dimorphic fungus Sporothrix schenckii. It commonly presents as lymphocutaneous or fixed cutaneous lesions involving the upper extremities with facial lesions being seen more often in children. The lesions are polymorphic. The therapeutic response to saturated solution of potassium iodide is almost diagnostic.We describe a culture-proven case of cutaneous sporotrichosis of the face mimicking lupus vulgaris initially and basal cell carcinoma later, who did not tolerate potassium iodide and failed to respond to treatment with fluconazole. The patient had reactivation of infection following an infiltration of the scar with triamcinolone acetonide injection. Various other aspects of these unusual phenomena are also discussed. .com). Key Words: Cicatricial -
VORICONAZOLE Persists, Consult Your Doctor
may come back. If the infection worsens or should avoid driving, using machinery or VORICONAZOLE persists, consult your doctor. doing something that may be dangerous if your vision is impaired. Notify your doctor if Other NAMES: Vfend What should you do if you FORGET a your vision changes or if bright lights are dose? bothersome. WHY is this drug prescribed? If you miss a dose voriconazole, take it as What other PRECAUTIONS should you Voriconazole is an antifungal drug. It is used soon as possible. However, if it is time for follow while using this drug? to treat a variety of fungal infections (candida, your next dose, do not double the dose, just aspergillosis) in the mouth (like thrush), carry on with your regular schedule. Before starting voriconazole, please inform esophagus, lungs, blood and in other areas. your doctor if you have ever developed an What ADVERSE EFFECTS can this drug allergy to voriconazole or to similar drugs HOW should this drug be taken? cause? What should you do about them? [ketoconazole (Nizoral ), fluconazole (Diflucan ), itraconazole (Sporanox ). Also Voriconazole is available as 50 mg and 200 Voriconazole may cause some stomach notify your doctor if you have kidney, liver or mg tablets. During the first days of therapy, it upset, nausea, vomiting and loss of vision problems. can also be given by intravenous (I.V.: in the appetite . Some other potential adverse veins) injections. The intravenous injections effects are abdominal pain, diarrhea, and Certain drugs can increase or decrease the will be given over a 1 to 2 hour period, likely headache . -
Miltefosine Treatment Reduces Visceral Hypersensitivity in a Rat Model For
www.nature.com/scientificreports OPEN Miltefosine treatment reduces visceral hypersensitivity in a rat model for irritable bowel syndrome Received: 28 February 2019 Accepted: 2 August 2019 via multiple mechanisms Published: xx xx xxxx Sara Botschuijver1, Sophie A. van Diest1, Isabelle A. M. van Thiel 1, Rafael S. Saia1,2, Anne S. Strik1,3, Zhumei Yu1,4,9, Daniele Maria-Ferreira 1,5, Olaf Welting1, Daniel Keszthelyi6, Gary Jennings7, Sigrid E. M. Heinsbroek1,3, Ronald P. Oude Elferink 1,3, Frank H. J. Schuren 8, Wouter J. de Jonge1,3 & René M. van den Wijngaard1,3 Irritable bowel syndrome (IBS) is a heterogenic, functional gastrointestinal disorder of the gut-brain axis characterized by altered bowel habit and abdominal pain. Preclinical and clinical results suggested that, in part of these patients, pain may result from fungal induced release of mast cell derived histamine, subsequent activation of sensory aferent expressed histamine-1 receptors and related sensitization of the nociceptive transient reporter potential channel V1 (TRPV1)-ion channel. TRPV1 gating properties are regulated in lipid rafts. Miltefosine, an approved drug for the treatment of visceral Leishmaniasis, has fungicidal efects and is a known lipid raft modulator. We anticipated that miltefosine may act on diferent mechanistic levels of fungal-induced abdominal pain and may be repurposed to IBS. In the IBS-like rat model of maternal separation we assessed the visceromotor response to colonic distension as indirect readout for abdominal pain. Miltefosine reversed post-stress hypersensitivity to distension (i.e. visceral hypersensitivity) and this was associated with diferences in the fungal microbiome (i.e. mycobiome).