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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Salvage therapy for invasive aspergillosis
1Section of Infection, Inflammation and Immunity, University of Sheffield School of Medicine and Biomedical Sciences, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. d.h.dockrell@sheffield.ac.uk
The Journal of Antimicrobial Chemotherapy
|February 15, 2008
Summary
Salvage therapy for invasive aspergillosis (IA) in immunocompromised patients yields disappointing results. Early diagnosis and primary treatment are crucial, though several antifungal agents show promise in salvage settings.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Invasive aspergillosis (IA) is a significant cause of mortality in immunocompromised individuals, particularly those undergoing chemotherapy or stem cell transplantation.
- Salvage therapy is defined as treatment for invasive fungal infections unresponsive or intolerant to initial therapies for at least seven days.
Purpose of the Study:
- To review the efficacy of various antifungal agents and treatment strategies in the salvage therapy of invasive aspergillosis.
- To highlight the limitations of current clinical trials and emphasize the need for further research in optimizing IA salvage treatment.
Main Methods:
- Review of clinical trials and studies investigating salvage therapy for invasive aspergillosis.
- Analysis of treatment outcomes for various antifungal agents, including lipid formulations of amphotericin B, echinocandins, and azoles.
Main Results:
- Salvage therapy for IA has generally produced disappointing outcomes, underscoring the importance of timely diagnosis and primary treatment.
- Several antifungal agents, such as lipid-based amphotericin B, caspofungin, itraconazole, voriconazole, posaconazole, and micafungin, have demonstrated efficacy in salvage settings.
- Combination therapies involving echinocandins with azoles or amphotericin B have been explored in limited studies.
Conclusions:
- Optimal salvage treatment for invasive aspergillosis remains challenging, with current approaches yielding suboptimal results.
- Further randomized clinical trials are essential to compare newer agents and treatment strategies for IA salvage therapy in high-risk patient populations.
