Article information
Resumen
El incremento de la frecuencia y morbimortalidad de las infecciones fúngicas ha hecho necesaria la disponibilidad de nuevos antifúngicos. Candida spp. y Aspergillus spp. son los agentes más frecuentemente productores de micosis graves en pacientes críticos e inmunodeprimidos, pero otros hongos emergentes deben ser considerados. El uso racional y precoz de los antifúngicos debe combinar procedimientos diagnósticos microbiológicos y de imagen. En la medida que las nuevas opciones terapéuticas suponen un avance su complejidad también ha aumentado. En los últimos años, 3 nuevos antifúngicos (micafungina, anidulafungina y posaconazol) se han añadido al armamento terapéutico de estas infecciones. Este artículo incluye una actualización, a la luz de las últimas evidencias científicas, de la eficacia clínica, farmacocinética, seguridad y dosificación de los diferentes antifúngicos disponibles en la actualidad para el tratamiento de las infecciones por Candida spp., Aspergillus spp., Cryptococcus spp., zygomycetos, Scedosporium spp. y Fusarium spp.
Palabras clave:
Tratamiento antifúngico
Actualización
Infección fúngica invasiva
Abstract
Increases in the rates of fungal infections, as well as their associated morbidity and mortality has led to a need for additional antifungal agents. The most common serious fungal agents in immunosuppressed and critically ill patients are Candida spp. and Aspergillus spp., although other emerging fungi must be considered. Rational, early systemic antifungal treatment should be based on diagnostic imaging techniques and conventional mycological and non-culture-based procedures. While the availability of new therapeutic options is an important advance, antifungal therapy has become increasingly complex. In addition to the available antifungal armamentarium, recent research has resulted in the introduction of three new antifungal agents: micafungin, anidulafungin, and posaconazole. This article provides an update, based on the latest scientific evidence, of the clinical efficacy, pharmacokinetics, safety and dosing of antifungal drugs administered in the management of Candida spp., Aspergillus spp., Cryptococcus spp., Zygomycetes, Scedosporium spp. and Fusarium spp.
Keywords:
Antifungal therapy
Update
Invasive fungal infections
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