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Novak AR, Bradley ME, Kiser TH, et al. Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?. Curr Fungal Infect Rep. 2020;14(2):141-152doi: 10.1007/s12281-020-00379-2.
Novak, A. R., Bradley, M. E., Kiser, T. H., & Mueller, S. W. (2020). Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?. Current fungal infection reports, 14(2), 141-152. https://doi.org/10.1007/s12281-020-00379-2
Novak, Alison R, et al. "Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?." Current fungal infection reports vol. 14,2 (2020): 141-152. doi: https://doi.org/10.1007/s12281-020-00379-2
Novak AR, Bradley ME, Kiser TH, Mueller SW. Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?. Curr Fungal Infect Rep. 2020 Jun;14(2):141-152. doi: 10.1007/s12281-020-00379-2. Epub 2020 Mar 26. PMID: 32699568; PMCID: PMC7375389.
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Curr Fungal Infect Rep. 2020 Jun;14(2):141-152. doi: 10.1007/s12281-020-00379-2. Epub 2020 Mar 26.

Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?.

Current fungal infection reports

Alison R Novak, Mary E Bradley, Tyree H Kiser, Scott W Mueller

Affiliations

  1. Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Boulevard, Mail Stop C238, Aurora, CO 80045, USA.

PMID: 32699568 PMCID: PMC7375389 DOI: 10.1007/s12281-020-00379-2

Abstract

PURPOSE OF REVIEW: This review summarizes current treatment options for echinocandin-resistant

RECENT FINDINGS: Advances in ERC and ARAF treatment are limited to specific antifungal combinations and dose optimization but remain reliant on amphotericin products. Although novel antifungals may provide breakthroughs in the treatment of resistant fungi, these agents are not yet available. Early identification and appropriate treatment remain a paramount, albeit elusive, task.

SUMMARY: When either ERC or ARAF are suspected or proven, amphotericin products remain the cornerstone of initial therapy. For ERC, azoles are de-escalation options for susceptible isolates in stable patients to avoid amphotericin toxicities. Although combination echinocandin with high-dose salvage posaconazole or isavuconazole may be attempted in ARAF, it requires careful consideration following patient stabilization. Future research defining optimal therapies and early identification of ERC and ARAF is of extreme importance.

Keywords: Amphotericin; Anidulafungin; Antifungal; Azole-Resistant Aspergillus; Caspofungin; Echinocandin-Resistant Candida; Invasive Fungal Infection; Isavuconazole; Micafungin; Posaconazole; Resistance; Voriconazole

Conflict of interest statement

Compliance with Ethics Guidelines Conflict of Interest

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