Management of Drug-Drug Interaction between Everolimus and Azole Antifungals in a Cardiac Transplant Patient
نویسندگان
چکیده
A 64-year-old Caucasian male was admitted to the infectious disease department in May 2016 for exploration of a febrile syndrome lasting for two months associated with chronic cough for 1 year. He was treated by Everolimus (Certican®) 1 mg bid since 2011 as anti-rejection drug after cardiac transplantation in 1990. His treatment also included Atorvastatin 10mg/d, Ezetimibe 10mg/d, Prasugrel 10mg/d, Aspirin 75mg/d, Pantoprazole 20mg/d, and Valsartan 80mg/d. Initial physical and morphologic assessment disclosed an upper maxillary dental abscess associated with a contiguous sinusitis and basal lung nodular infiltrates. Aspergillus serology was positive using an ELISA, but not confirmed by Western blot. Plasmatic galactomannan testing was negative. Bronchoalveolar lavage fluid analysis was negative, including bacteriological and mycological analysis, and galactomannan testing. An antimicrobial therapy with amoxicillin/clavulanic acid and appropriate dental cares allowed improvement of local abnormalities, but fever and lung nodular infiltrates persisted.
منابع مشابه
Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants.
The magnitude of drug interactions between azole antifungals and immunosuppressants is drug and patient specific and depends on the potency of the azole inhibitor involved, the resulting plasma concentrations of each drug, the drug formulation, and interpatient variability. Many factors contribute to variability in the magnitude and clinical significance of drug interactions between an immunosu...
متن کاملDrug-Drug Interaction Clinical Decision Support Systems: Advantages, Challenges and Barriers, and Strategies to Overcome Them
Drug-drug interactions (DDIs) are a common source of preventable medical errors in inpatient and outpatient settings of both developed and developing countries. When two or more drugs are simultaneously prescribed, interactions between their effects may result in preventable adverse events such as damages to vital organs, frequent hospitalizations, prolonged length of hospital stay, and increas...
متن کاملDrug-Drug Interaction Clinical Decision Support Systems: Advantages, Challenges and Barriers, and Strategies to Overcome Them
Drug-drug interactions (DDIs) are a common source of preventable medical errors in inpatient and outpatient settings of both developed and developing countries. When two or more drugs are simultaneously prescribed, interactions between their effects may result in preventable adverse events such as damages to vital organs, frequent hospitalizations, prolonged length of hospital stay, and increas...
متن کاملA Review on Therapeutic Drug Monitoring of Immunosuppressant Drugs
Immunosuppressants require therapeutic drug monitoring because of their narrow therapeutic index and significant inter-individual variability in blood concentrations. This variability can be because of factors like drug-nutrient interactions, drug-disease interactions, renal-insufficiency, inflammation and infection, gender, age, polymorphism and liver mass. Drug monitoring is widely practiced ...
متن کاملA Review of Antifungals and their Mono- and Combination- therapy in the Treatment of Invasive Fungal Infections
Invasive fungal infections with high mortality rate are a growing health concern in hospitals and medical centers. The infection usually occurs in people with compromised immune systems. The purpose of this paper is a review of the most commonly prescribed antifungal drugs for invasive fungal diseases. Antifungals consist of the four main groups; polyenes, azoles, echinocandins and DNA an...
متن کامل