Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Jan 2001
ReviewChanging spectrum of invasive candidiasis and its therapeutic implications.
Emerging trends in invasive candidiasis are notable for a dramatic increase in infections due to non-albicans Candida species. An increasing number of immunocompromised patients at risk from fungal infections, an overall greater acuity of illness in the hospitalized patients, particularly those in the critical care units, escalating rates of broad-spectrum antibiotic usage, and wide utilization of azoles as prophylaxis have probably contributed towards the changing epidemiology of invasive candidiasis. Given the inherent decreased susceptibility of many of the non-albicans Candida species to currently available antifungal agents, these evolving trends have far-reaching clinical relevance.
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Clin. Microbiol. Infect. · Jan 2001
ReviewLiposomal amphotericin B (AmBisome) for fungal infections in immunocompromised adults and children.
Invasive fungal infections are rare but life-threatening infections, most often occurring in immunocompromised patients. For a long time, Amphotericin B has been the best choice for treatment, because it is fungicidal with a broad antifungal spectrum and minimal risk of resistance development. The therapeutic use of amphotericin B has, however, been limited by its toxicity-both acute as well as chronic. ⋯ In uncontrolled and, more recently, in randomized controlled studies at other centers, AmBisome has revealed less toxicity and an efficacy equal or superior to that of the conventional drug in treating neutropenia-associated fever and proven invasive fungal infections in both adults as well as in children. Although investigators tend to increase the dose used, the optimal dose for probable or proven infection is still under debate. Based on our own experience in using AmBisome and the experience at other centers, we can conclude that AmBisome represents a major breakthrough in the treatment of invasive fungal infections, especially in immunocompromised patients.