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Adverse drug reactions to systemic antifungals. Prevention and management
J R Perfect1, M H Lindsay, R H Drew
1Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Abstract:
Systemic administration of antifungal agents for invasive mycoses has dramatically increased over the past 10 years in many fields of medicine. The increase has been due both to an increasing immune compromised population and to potent antibacterial agents which allow these fungi to invade tissue. It is apparent that our understanding of the use of both the old and new antifungal agents has significantly increased in the last few years. In this review, we attempt to document our extensive knowledge of the adverse effects of the polyenes, flucytosine, griseofulvin and azoles when given systemically for treatment. Interwoven in this documentation of the adverse reactions to these agents is the attempt to help clinicians potentially avoid some of these adverse effects and if they do occur, to be able to identify and successfully manage them.
Insights
Systemic antifungal use for invasive mycoses is rising due to immunocompromised patients. This review details adverse effects of polyenes, flucytosine, griseofulvin, and azoles to aid clinical management.
Area of Science:
- Medical Mycology
- Pharmacology
- Infectious Diseases
Background:
- Increasing incidence of invasive fungal infections (mycoses) driven by immunocompromised populations and broad-spectrum antibiotics.
- Significant advancements in understanding and utilizing both established and novel antifungal therapies over recent years.
Purpose of the Study:
- To comprehensively review the adverse effects associated with systemic antifungal agents.
- To provide guidance for clinicians on preventing, identifying, and managing adverse reactions to commonly used antifungals.
Main Methods:
- Literature review focusing on adverse effects of systemic antifungal medications.
- Synthesis of current knowledge on polyenes, flucytosine, griseofulvin, and azoles.
Main Results:
- Detailed documentation of known adverse effects for each major class of systemic antifungal agents.
- Identification of strategies to mitigate and manage these adverse events in clinical practice.
Conclusions:
- Effective management of invasive mycoses requires a thorough understanding of antifungal drug toxicities.
- Clinicians can improve patient outcomes by proactively addressing and managing the adverse effects of systemic antifungal treatments.