The incidence of invasive fungal infections has been on the rise, particularly in transplant recipients and in patients with hematological malignancies and other forms of immunosuppression. There is a mismatch between the rate of antifungal resistance and the development of new antifungal agents. Based on this, the idea of combining antifungals in the treatment of invasive fungal infections app...

Caspofungin is the first member of the echinocandin class of antifungals to receive an indication for the use in infants, children, and adolescents from the United States Food and Drug Administration. Daily doses of 50 mg/m(2) result in pharmacokinetic parameters that are similar to those observed in adults. Although fewer data are available, the response rates in pediatric patients who receive...

Ergosterol, the major sterol of fungal membranes, is essential for developmental growth and the main target of antifungals that are currently used to treat fatal fungal infections. Emergence of resistance to existing antifungals is a current problem and several secondary resistance mechanisms have been described in Aspergillus fumigatus clinical isolates. A full understanding of ergosterol bios...

Cytochrome P-450 catalysing the 14ademethylation of sterol is inhibited in fungi by azole antifungal compounds resulting in a fungistatic or a fungicidal effect [ 11. The azoles themselves represent a useful tool for investigating P-450 structure through the differential affinities with different P450 forms. [Z]. Of practical importance is the identification of the molecular features which resu...

The introduction of several new antifungals has significantly expanded both prophylaxis and treatment options for invasive fungal infections (IFIs). Relative to amphotericin B deoxycholate, lipid-based formulations of amphotericin B have significantly reduced the incidence of nephrotoxicity, but at a significant increase in drug acquisition cost. Newer, broad-spectrum triazoles (notably voricon...

Bisphosphonates have shown significant clinical benefit in reducing skeletal fractures in patients with multiple myeloma or bone: penicillin VK 500 mg or amoxicillin 500 mg; both 4 times daily (QID) initially and twice daily (BID) for maintenance, If penicillin allergic: 1. Clindamycin 150 to 300 mg QID. 2. Vibramycin 100 mg once daily (QD). 3. Erythromycin ethylsuccinate 400 mg 3 times daily (...