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J. Fungi 2018, 4(4), 133;

Pre-Existing Liver Disease and Toxicity of Antifungals

Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, P.O. Box 1352, 71110 Heraklion, Crete, Greece
School of Medicine, University of Crete, 71110 Heraklion, Crete, Greece
Author to whom correspondence should be addressed.
Received: 30 October 2018 / Revised: 5 December 2018 / Accepted: 7 December 2018 / Published: 10 December 2018
(This article belongs to the Special Issue Fungal Infections in Immunocompromised Hosts)
Full-Text   |   PDF [307 KB, uploaded 10 December 2018]


Pre-existing liver disease in patients with invasive fungal infections further complicates their management. Altered pharmacokinetics and tolerance issues of antifungal drugs are important concerns. Adjustment of the dosage of antifungal agents in these cases can be challenging given that current evidence to guide decision-making is limited. This comprehensive review aims to evaluate the existing evidence related to antifungal treatment in individuals with liver dysfunction. This article also provides suggestions for dosage adjustment of antifungal drugs in patients with varying degrees of hepatic impairment, after accounting for established or emerging pharmacokinetic–pharmacodynamic relationships with regard to antifungal drug efficacy in vivo. View Full-Text
Keywords: liver disease; hepatic impairment; invasive fungal infection; antifungal agent; antifungal drug; toxicity liver disease; hepatic impairment; invasive fungal infection; antifungal agent; antifungal drug; toxicity
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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Spernovasilis, N.; Kofteridis, D.P. Pre-Existing Liver Disease and Toxicity of Antifungals. J. Fungi 2018, 4, 133.

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