Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Mar 2011
Review[Is micafungin useful in the prophylaxis of invasive fungal disease in hematological patients?].
Antifungal prophylaxis is the first option to fight against fungal infection in high-risk hematological patients (remission of induction of acute myeloblastic leukemia/myelodysplastic syndrome, allogeneic hematopoietic stem cell transplantation). Fluconazole prophylaxis is not effective in preventing infection with moulds, mainly invasive aspergillosis, and consequently the triazole currently recommended in high-risk hematological patients is posaconazole. Nevertheless, given that posaconazole can only be administered orally, alternative prophylaxis may be required. ⋯ Higher doses have been evaluated in adults (100 mg/day, 150 mg/day) and in children (3 mg/kg/day) with good efficacy and safety. Because of this agent's spectrum of activity, which includes both Candida and Aspergillus, together with its favorable pharmacokinetic profile regarding to the absence of significant drug interactions, this agent is appropriate in hematopoietic stem cell transplant recipients and in hematological patients following therapeutic protocols with vinca alkaloids. The optimal and most cost-effective dose for prophylaxis, as well as alternative regimens to daily intravenous administration, which would allow the use of this drug beyond conventional hospitalization (day care hospital, domiciliary transplantation therapy), remain to be determined.
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Enferm. Infecc. Microbiol. Clin. · Mar 2011
Review[Scientific evidence supporting the use of micafungin in the treatment of invasive candidiasis].
Micafungin is a semisynthetic lipopeptide developed from Coleophoma empetri, which blocks the synthesis of β-1,3-D-glucan, an essential component of the fungal wall, though non-competitive inhibition of β-1,3-D-glucan synthetase. Micafungin is a dose-dependent candidacidal agent with excellent in vitro efficacy against most Candida spp. including species resistant to amphotericin B, such as Candida lusitaniae, several azoles, such as C. glabrata or C. krusei, and isolates not susceptible to other echinocandins. ⋯ This drug is approved for use in the treatment of invasive candidiasis and Candida esophagitis, as well as in the prophylaxis of Candida infections in hematopoietic stem cell transplant recipients or those at risk of prolonged neutropenia. Micafungin can be used both in the treatment and prevention of candidiasis in neonates, children, adolescents, adults, and the elderly, making it highly useful in patient groups in which the use of other antifungal drugs has not been authorized.
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Enferm. Infecc. Microbiol. Clin. · Feb 2011
[Lymphogranuloma venereum proctocolitis in men with HIV-1 infection].
We present a series of 15 cases with lymphogranuloma venereum (LGV) with the aim of evaluating the response to a 21-day oral course of doxycycline (100mg twice daily). ⋯ A high index of clinical suspicion is the mainstay to the early diagnosis of LGV since the clinical presentation remains unspecific. The treatment with doxycycline eradicates C. trachomatis in HIV patients with LGV.