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Treatment principles for the management of mold infections
Dimitrios P Kontoyiannis1, Russell E Lewis2
1The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030.
Abstract:
Survival rates among immunocompromised patients with invasive mold infections have markedly improved over the last decade with earlier diagnosis and new antifungal treatment options. Yet, increasing antifungal resistance, breakthrough infections with intrinsically resistant fungi, and potentially life-threatening adverse effects and drug interactions are becoming more problematic, especially with prolonged therapy. Evidence-based recommendations for treating invasive aspergillosis and mucormycosis provide excellent guidance on the initial workup and treatment of these molds, but they cannot address all of the key management issues. Herein, we discuss 10 general treatment principles in the management of invasive mold disease in immunocompromised patients and discuss how these principles can be integrated to develop an effective, individualized treatment plan.
Insights
Survival rates for invasive mold infections in immunocompromised patients have improved due to earlier diagnosis and new antifungal treatments. However, challenges like antifungal resistance and treatment side effects necessitate individualized management plans.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunocompromised Host Management
Background:
- Invasive mold infections pose significant risks to immunocompromised patients.
- Advances in diagnosis and antifungal therapies have improved survival rates.
- Antifungal resistance, breakthrough infections, and treatment toxicities present ongoing challenges.
Purpose of the Study:
- To outline key principles for managing invasive mold diseases in immunocompromised individuals.
- To guide the integration of these principles into individualized treatment strategies.
Main Methods:
- Review of current evidence-based recommendations for invasive aspergillosis and mucormycosis.
- Discussion of 10 general treatment principles for invasive mold disease.
- Emphasis on integrating principles for personalized patient care.
Main Results:
- Improved survival with earlier diagnosis and novel antifungal agents.
- Increasing concerns regarding antifungal resistance and drug-related adverse events.
- Need for comprehensive management strategies beyond initial treatment guidelines.
Conclusions:
- Effective management of invasive mold disease requires addressing challenges like resistance and toxicity.
- Individualized treatment plans are crucial for optimizing outcomes in immunocompromised patients.
- Adherence to 10 general treatment principles can enhance patient care and survival rates.
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