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J. Fungi 2015, 1(3), 345-366; doi:10.3390/jof1030345

Role of New Antifungal Agents in the Treatment of Invasive Fungal Infections in Transplant Recipients: Isavuconazole and New Posaconazole Formulations

1
Department of Pharmacy, Ochsner Medical Center, New Orleans, LA 70123, USA
2
Department of Infectious Diseases, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70123, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Shmuel Shoham
Received: 2 July 2015 / Revised: 6 October 2015 / Accepted: 6 October 2015 / Published: 15 October 2015
(This article belongs to the Special Issue Fungal Infections in Transplant Recipients)
View Full-Text   |   Download PDF [715 KB, uploaded 15 October 2015]

Abstract

Invasive fungal infections are a major cause of morbidity and mortality among solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Transplant patients are at risk for such invasive fungal infections. The most common invasive fungal infections are invasive candidiasis in the SOT and invasive aspergillosis in the HSCT. In this article, we will discuss the epidemiology of invasive fungal infections in the transplant recipients and susceptibility patterns of the fungi associated with these infections. Additionally, the pharmacology and clinical efficacy of the new antifungal, isavuconazole, and the new posaconazole formulations will be reviewed. Isavuconazole is a new extended-spectrum triazole that was recently approved for the treatment of invasive aspergillosis and mucormycosis. Advantages of this triazole include the availability of a water-soluble intravenous formulation, excellent bioavailability of the oral formulation, and predictable pharmacokinetics in adults. Posaconazole, a broad-spectrum triazole antifungal agent, is approved for the prevention of invasive aspergillosis and candidiasis in addition to the treatment of oropharyngeal candidiasis. Posaconazole oral suspension solution has shown some limitations in the setting of fasting state absorption, elevated gastrointestinal pH, and increased motility. The newly approved delayed-release oral tablet and intravenous solution formulations provide additional treatment options by reducing interpatient variability and providing flexibility in these set of critically ill patients. This review will detail these most recent studies. View Full-Text
Keywords: antifungals; transplantation; candidiasis; aspergillosis antifungals; transplantation; candidiasis; aspergillosis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Li, J.; Nguyen, C.T.; Garcia-Diaz, J. Role of New Antifungal Agents in the Treatment of Invasive Fungal Infections in Transplant Recipients: Isavuconazole and New Posaconazole Formulations. J. Fungi 2015, 1, 345-366.

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