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When to change treatment of acute invasive aspergillosis: an expert viewpoint.
Slavin, Monica A; Chen, Yee-Chun; Cordonnier, Catherine; Cornely, Oliver A; Cuenca-Estrella, Manuel; Donnelly, J Peter; Groll, Andreas H; Lortholary, Olivier; Marty, Francisco M; Nucci, Marcio; Rex, John H; Rijnders, Bart J A; Thompson, George R; Verweij, Paul E; White, P Lewis; Hargreaves, Ruth; Harvey, Emma; Maertens, Johan A.
Afiliación
  • Slavin MA; Department of Infectious Diseases, Peter MacCallum Cancer Centre, National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
  • Chen YC; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
  • Cordonnier C; Service d'Hématologie clinique et de Thérapie cellulaire, DMU Cancer, CHU Henri Mondor, 94000 Créteil, France.
  • Cornely OA; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.
  • Cuenca-Estrella M; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD); Clinical Trials Centre Cologne (ZKS Köln), Kerpener Str. 62, 50937 Cologne, Germany.
  • Donnelly JP; Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo Km2, Majadahonda, Madrid 28220, Spain.
  • Groll AH; Nijmegen, The Netherlands.
  • Lortholary O; Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany.
  • Marty FM; Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants Malades University Hospital, and Institute Pasteur, CNRS, Molecular Mycology Unit, APHP 149, rue de Sèvres, 75015 Paris, France.
  • Nucci M; Brigham and Women's Hospital, Boston, USA.
  • Rex JH; University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
  • Rijnders BJA; F2G Ltd, Lankro Way, Eccles, Manchester, M30 0LX, UK.
  • Thompson GR; McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
  • Verweij PE; Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • White PL; Department of Internal Medicine, Division of Infectious Diseases, 4150 V Street, Suite G500, Sacramento, CA 95817, USA.
  • Hargreaves R; Radboudumc-CWZ Center of Expertise for Mycology, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
  • Harvey E; Center for Infectious Disease Research, Diagnostics and Laboratory Surveillance National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
  • Maertens JA; Public Health Wales Mycology Reference Laboratory, University Hospital of Wales, Heath Park, Cardiff, UK.
J Antimicrob Chemother ; 77(1): 16-23, 2021 12 24.
Article en En | MEDLINE | ID: mdl-34508633
Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with ≥2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aspergilosis / Aspergilosis Pulmonar Invasiva / Infecciones Fúngicas Invasoras Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aspergilosis / Aspergilosis Pulmonar Invasiva / Infecciones Fúngicas Invasoras Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido