Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol

Randomized clinical trials in systemic antifungal therapy have traditionally been focused on patients with systemic candidiasis, cryptococcal meningitis, invasive aspergillosis and febrile neutropenic patients with suspicion of a fungal infection. The latter is a known risk factor for infection with...

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Autor principal:	FICA C.,ALBERTO
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Chilena de Infectología 2004
Materias:	Invasive mycosis Systemic antifungal agents Fluconazole Itraconazole Voriconazole
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000100004
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spelling	oai:scielo:S0716-101820040001000042004-05-05Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazolFICA C.,ALBERTO Invasive mycosis Systemic antifungal agents Fluconazole Itraconazole Voriconazole Randomized clinical trials in systemic antifungal therapy have traditionally been focused on patients with systemic candidiasis, cryptococcal meningitis, invasive aspergillosis and febrile neutropenic patients with suspicion of a fungal infection. The latter is a known risk factor for infection with filamentous fungi. Itraconazole and voriconazole are active against molds when compared with fluconazole but they are not active against agents of mucormycosis. Both itraconazole and voriconazole cover clinical isolates of Candida albicans and non C. albicans isolates with natural or acquired resistance to fluconazole. Although every triazole compound can be applied on infection caused by C. albicans, only fluconazole has been validated in this setting. Moreover, this compound is the only one approved for the treatment of patients affected by low-risk cryptococcal meningitis. In patients with invasive aspergillosis, only voriconazole has been formally compared and found similar to amphotericin B although open-label studies with intravenous itraconazole also demonstrate its usefulness in this condition. In contrast, in neutropenic febrile patients with suspicion of a fungal infection, intravenous itraconazole but not voriconazole has been shown equivalent to amphotericin B. Triazole compounds differ each other in their dosing schedules, bioavailability, interference of food or changes in gastric pH in absorption, penetration to the CNS, time to reach plasma steady-state concentrations and acquisition costs. Intravenous presentations of itraconazole and voriconazole should not be administered when moderate or mild renal failure is present (< 30 vs < 50 ml/min of creatinine clearence, respectively).info:eu-repo/semantics/openAccessSociedad Chilena de InfectologíaRevista chilena de infectología v.21 n.1 20042004-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000100004es10.4067/S0716-10182004000100004
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Invasive mycosis Systemic antifungal agents Fluconazole Itraconazole Voriconazole
spellingShingle	Invasive mycosis Systemic antifungal agents Fluconazole Itraconazole Voriconazole FICA C.,ALBERTO Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
description	Randomized clinical trials in systemic antifungal therapy have traditionally been focused on patients with systemic candidiasis, cryptococcal meningitis, invasive aspergillosis and febrile neutropenic patients with suspicion of a fungal infection. The latter is a known risk factor for infection with filamentous fungi. Itraconazole and voriconazole are active against molds when compared with fluconazole but they are not active against agents of mucormycosis. Both itraconazole and voriconazole cover clinical isolates of Candida albicans and non C. albicans isolates with natural or acquired resistance to fluconazole. Although every triazole compound can be applied on infection caused by C. albicans, only fluconazole has been validated in this setting. Moreover, this compound is the only one approved for the treatment of patients affected by low-risk cryptococcal meningitis. In patients with invasive aspergillosis, only voriconazole has been formally compared and found similar to amphotericin B although open-label studies with intravenous itraconazole also demonstrate its usefulness in this condition. In contrast, in neutropenic febrile patients with suspicion of a fungal infection, intravenous itraconazole but not voriconazole has been shown equivalent to amphotericin B. Triazole compounds differ each other in their dosing schedules, bioavailability, interference of food or changes in gastric pH in absorption, penetration to the CNS, time to reach plasma steady-state concentrations and acquisition costs. Intravenous presentations of itraconazole and voriconazole should not be administered when moderate or mild renal failure is present (< 30 vs < 50 ml/min of creatinine clearence, respectively).
author	FICA C.,ALBERTO
author_facet	FICA C.,ALBERTO
author_sort	FICA C.,ALBERTO
title	Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
title_short	Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
title_full	Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
title_fullStr	Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
title_full_unstemmed	Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol
title_sort	tratamiento de infecciones fúngicas sistémicas primera parte: fluconazol, itraconazol y voriconazol
publisher	Sociedad Chilena de Infectología
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000100004
work_keys_str_mv	AT ficacalberto tratamientodeinfeccionesfungicassistemicasprimerapartefluconazolitraconazolyvoriconazol
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Tratamiento de infecciones fúngicas sistémicas Primera parte: fluconazol, itraconazol y voriconazol

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