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Am J Ther. 2012 Jan;19(1):51-63. doi: 10.1097/MJT.0b013e3181ff7e10.

Importance of pharmacokinetic considerations for selecting therapy in the treatment of invasive fungal infections.

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Department of Clinical and Experimental Pharmacology, University of Houston College of Pharmacy, Houston, TX 77030, USA.


Invasive fungal infections continue to be a significant cause of morbidity and mortality among at-risk patients. Over the last decade, the epidemiology of invasive mycoses has been defined by increasing rates of infection caused by azole-resistant yeast (Candida glabrata, Candida krusei), Aspergillus, and in some centers, non-Aspergillus moulds, such as Fusarium species, Scedosporium species, and Mucorales. Early and appropriate antifungal therapy is crucial for a favorable clinical outcome. When selecting antifungal therapy--especially during the initial acute phases of treatment--spectrum of activity and pharmacokinetic characteristics are key treatment considerations. Important pharmacokinetic considerations for selecting antifungal therapy in the treatment of invasive fungal infections include drug-drug interactions and variability in adsorption that may limit efficacy during the early phase of treatment, poor oral availability, and variable tissue distribution. A patient's underlying condition and pharmacogenetics also may affect the pharmacokinetics of antifungal drugs, resulting in interpatient pharmacokinetic differences.

[Indexed for MEDLINE]

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