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posaconazole

Amphotericin B, posaconazole, and aggressive surgical resection are the hallmarks of mucormycosis treatment. While amphotericin is typically administered intravenously, less is known about the use of intrathecal amphotericin B 1).


Cladophialophora bantiana tends to be resistant to amphotericin B. Accordingly, Al-Abdely et al. evaluated amphotericin B and three triazoles–posaconazole, itraconazole, and fluconazole–for treatment of C. bantiana infection in mice. In immunosuppressed ICR mice infected intravenously, posaconazole, itraconazole, and amphotericin B prolonged survival. This improvement in survival corresponded with a reduction in brain fungal concentrations for mice which were given itraconazole and posaconazole, but not amphotericin B. In nonimmunosuppressed BALB/c mice infected intracerebrally, posaconazole showed dose-dependent responses in survival and reduction of brain tissue counts. These responses were observed for short, delayed, and prolonged therapy. Although posaconazole prolonged the survival of mice with reductions in brain fungal counts, it did not sterilize brain tissue with continuous therapy for 8 weeks. They concluded that posaconazole shows promise for the treatment of C. bantiana brain infections 2).

1)
Grannan BL, Yanamadala V, Venteicher AS, Walcott BP, Barr JC. Use of external ventriculostomy and intrathecal anti-fungal treatment in cerebral mucormycotic abscess. J Clin Neurosci. 2014 May 19. pii: S0967-5868(14)00167-2. doi: 10.1016/j.jocn.2014.01.008. [Epub ahead of print] PubMed PMID: 24852901.
2)
Al-Abdely HM, Najvar LK, Bocanegra R, Graybill JR. Antifungal therapy of experimental cerebral phaeohyphomycosis due to Cladophialophora bantiana. Antimicrob Agents Chemother. 2005 May;49(5):1701-7. PubMed PMID: 15855484; PubMed Central PMCID: PMC1087650.
posaconazole.txt · Last modified: 2017/08/22 18:44 by administrador