地方性真菌病——我们在管理方面取得了进展吗?

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI:10.1097/QCO.0000000000000971
Nathan C Bahr, George R Thompson
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引用次数: 0

摘要

综述目的:地方性真菌是影响患者发病率和死亡率的重要原因。随着在传统地区以外观察到的感染,这些疾病的流行范围正在扩大。强化诊断和治疗实践可能会显著改变患者的预后。最近的发现:最近完成的临床试验侧重于评估在最大限度地减少患者毒性的同时提高疗效。组织胞浆菌病的实践改变试验已经完成,显示了单次前向脂质体两性霉素B剂量和标准伊曲康唑剂量的效用。最近对包括伊苏唑醇在内的几种抗真菌药物治疗球虫病的评估也显示出了额外治疗药物的前景。最近进行的一项试验也表明,两性霉素B治疗距骨真菌病的疗效优于伊曲康唑。摘要:地方性真菌病范围的增加,加上免疫功能低下患者群体的增加,要求继续研究改进的诊断和治疗方案。这些领域的进展导致了更快速的诊断和更有效的抗真菌治疗。
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Endemic mycoses - are we making progress in management?

Purpose of review: The endemic fungi are a significant cause of morbidity and mortality in effected patients. The range of endemicity for these are expanding with infections observed outside of traditional locations. Enhanced diagnostic and treatment practices may significantly alter patient outcomes.

Recent findings: Recently completed clinical trials have focused on an assessment of improving efficacy while minimizing patient toxicity. Practice changing trials have been completed in histoplasmosis showing the utility of a single up-front liposomal amphotericin B dose followed by standard itraconazole dosing. The recent evaluation of several antifungal options including isauvconazole in the treatment of coccidioidomycosis also show promise for additional therapeutic agents. A recently conducted trial has also shown the superiority of amphotericin B therapy over itraconazole in the treatment of talaromycosis.

Summary: The increased range of endemic mycoses coupled with the growing immunocompromised patient population mandates continued investigation of improved diagnostic and therapeutic options. Advances in these areas have led to more rapid diagnosis and more efficacious antifungal therapy.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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