The rationale of combination antifungal therapy in severely immunocompromised patients: Empiricism versus evidence-based medicine

Current Opinion in Infectious Diseases

Volumn 19, Issue 4, 2006, Pages 380-385

  Chamilos, Georgios ^a   Kontoyiannis, Dimitrios P ^a  

^a UNIVERSITY OF TEXAS   (United States)

Author keywords

Aspergillus; Candida; Combination therapy; Cryptococcus; Molds

Indexed keywords

AMPHOTERICIN B; AMPHOTERICIN B LIPID COMPLEX; ANTIFUNGAL AGENT; ANTIRETROVIRUS AGENT; CASPOFUNGIN; CORTICOSTEROID; ECHINOCANDIN; FLUCONAZOLE; FLUCYTOSINE; GAMMA INTERFERON; ITRACONAZOLE; MICAFUNGIN; POLYENE; POSACONAZOLE; TERBINAFINE; TRIAZOLE DERIVATIVE; VORICONAZOLE;

ASPERGILLOSIS; ASPERGILLUS; CANDIDA; CANDIDIASIS; CRYPTOCOCCOSIS; DISEASE SEVERITY; EVIDENCE BASED MEDICINE; FUNGAL MENINGITIS; HIGH RISK PATIENT; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENT; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; IMMUNOTHERAPY; MYCOSIS; NEUTROPENIA; NONHUMAN; REVIEW;

ANTIFUNGAL AGENTS; ASPERGILLOSIS; CANDIDIASIS; DRUG THERAPY, COMBINATION; EMPIRICISM; EVIDENCE-BASED MEDICINE; HUMANS; IMMUNOCOMPROMISED HOST; MYCOSES;

EID: 33745617129     PISSN: 09517375     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.qco.0000235166.16421.e5     Document Type: Review

References (35)

1. Gudlaugsson O, Gillespie S, Lee K, et al. Attributable mortality of nosocomial candidemia, revised. Clin Infect Dis 2003; 37:1172-1177.
2. Pappas PG, Rex JH, Lee J, et al. NIAID Mycoses study group. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis 2003; 37:634-643.
3. Kontoyiannis DP, Bodey GP. Invasive aspergillosis in 2002: an update. Eur J Clin Microbiol Infect Dis 2002; 21:161-172.
4. Nucci M, Marr KA. Emerging fungal diseases. Clin Infect Dis 2005; 41:521-526.
5. Lewis RE, Kontoyiannis DP. Combination chemotherapy for invasive fungal infections: what laboratory and clinical studies tell us so far. Drug Resist Updat 2003; 6:257-269.
6. Mukherjee PK, Sheehan DJ, Hitchcock CA, Ghannoum AM. Combination treatment of invasive fungal infections. Clin Microbiol Rev 2005; 12:163-194.
7. Kontoyiannis DP, Lionakis MS, Lewis RE, et al. Zygomycosis in the era of Aspergillus-active antifungal therapy in a tertiary care cancer center: a case-control observational study of 27 recent cases. J Infect Dis 2005; 191:1350-1360. This observational case-control study demonstrated that VRC prophylaxis was an independent risk factor for zygomycosis in high-risk patients with hematological malignancies and/or recipients of allogeneic HSCTs.
8. Matsue K, Uryu H, Koseki M, et al. Breakthrough trichosporonosis in patients with hematologic malignancies receiving micafungin. Clin Infect Dis 2006; 42:753-757.
9. Chamilos G, Luna M, Lewis RE, et al. Invasive fungal infections in patients with hematological malignancies (1989-2003): an autopsy study. Washington, DC: 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); 2005. Abstract #M-1720.
10. Steinbach WJ, Benjamin DK, Kontoyiannis DP, et al. Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases. Clin Infect Dis 2004; 39:192-198.
11. Pavie J, Lacroix C, Hermoso DG, et al. Breakthrough disseminated Aspergillus ustus infection in allogeneic hematopoietic stem cell transplant recipients receiving voriconazole or caspofungin prophylaxis. J Clin Microbiol 2005; 43:4902-4904.
12. Balajee SA, Weaver M, Imhof A, et al. Aspergillus fumigatus variant with decreased susceptibility to multiple antifungals. Antimicrob Agents Chemother 2004; 48:1197-1203.
13. Krogh-Madsen M, Arendrup MC, Heslet L, et al. Amphotericin B and caspofungin resistance in Candida glabrata isolates recovered from a critically ill patient. Clin Infect Dis 2006; 42:938-944.
14. Bellocchio S, Gaziano R, Bozza S, et al. Liposomal amphotericin B activates antifungal resistance with reduced toxicity by diverting Toll-like receptor signaling from TLR-2 to TLR-4. J Antimicrob Chemother 2005; 55:214-222.
15. Lewis RE, Chamilos G, Komanduri KV, et al. Liposomal amphotericin B is superior to amphotericin B deoxycholate in reducing inflammatory lung injury and fungal burden in corticosteroid-treated mice with invasive pulmonary aspergillosis. Washington, DC: 45th Annual Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); 2005. Abstract #A-1028.
16. Brouwer AE, Rajanuwong A, Chierakul W, et al. Combination antifungal therapies for HIV-associated cryptococcal meningitis: a randomised trial. Lancet 2004; 363:1764-1767.
17. Pappas PG, Bustamante B, Ticona E, et al. Recombinant interferon-gamma 1b as adjunctive therapy for AIDS-related acute cryptococcal meningitis. J Infect Dis 2004; 189:2185-2191.
18. Pappas PG, Rex JH, Sobel JD, et al. Guidelines for treatment of candidiasis. Clin Infect Dis 2004; 38:161-189.
19. Rex JH, Pappas PG, Karchmer AW, et al. A randomized and blinded multicenter trial of high-dose fluconazole plus placebo versus fluconazole plus amphotericin B as therapy for candidemia and its consequences in nonneutropenic patients. Clin Infect Dis 2003; 36:1221-1228.
20. Boktour MR, Kontoyiannis DP, Hanna HA, et al. Multiple-species candidemia in patients with cancer. Cancer 2004; 101:1860-1865.
21. Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347:408-415.
22. Kontoyiannis DP, Boktour M, Hanna H, et al. Itraconazole added to a lipid formulation of amphotericin B does not improve outcome of primary treatment of invasive aspergillosis. Cancer 2005; 103:2334-2337.
23. Meletiadis J, Stergiopoulou T, Petraitiene R, et al. Antagonistic interaction between amphotericin B (AMB) and ravuconazole (RAV) using the bliss independence drug interaction (BIDI) model: in vitro and in vivo correlations. Washington, DC: 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); 2005. Abstract #M-1385.
24. Petraitis V, Petraitiene R, Sarafandi A, et al. Combination therapy in treatment of experimental pulmonary aspergillosis: synergistic interaction between an antifungal triazole and an echinocandin. J Infect Dis 2003; 187:1834-1843.
25. Singh N, Limaye AP, Forrest G, et al. Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. Transplantation 2006; 81:320-326. This is the first prospective study suggesting that the combination of caspofungin and voriconazole might be of value as front-line therapy for invasive aspergillosis in the most severely immunocompromised solid organ transplant recipients with invasive aspergillosis. In addition, a lack of correlation between in-vitro synergy of caspofungin and voriconazole with clinical outcome demonstrates the challenges in studying antifungal combinations in vitro.
26. Marr KA, Boeckh M, Carter RA, et al. Combination antifungal therapy for invasive aspergillosis. Clin Infect Dis 2004; 39:797-802.
27. Maertens J, Glasmacher A, Herbercht R, et al. Multicenter, noncomparative study of caspofungin combined with other antifungals in adults with invasive aspergillosis refractory or intolerant to prior therapy: final data. Washington, DC: 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); 2005. Abstract M#954.
28. Caillot D, Thiebaut A, Herbercht R, et al. Liposomal amphotericin B in combination with caspofungin versus liposomal amphotericin B high dose regimen for the treatment of invasive aspergillosis in immunocompromised patients: Randomized pilot study (Combistrat trial). Las Vegas, NV: 16th Congress of the International Society for Human and Animal Mycology (Focus on Fungal Infections 16); 8-10 March, 2006.
29. Aliff TB, Maslak PG, Jurcic JG, et al. Refractory aspergillus pneumonia in patients with acute leukemia: successful therapy with combination of caspofungin and lipososmal amphotericin B. Cancer 2003; 97:1025-1032.
30. Kontoyiannis DP, Hachem R, Lewis RE, et al. Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies. Cancer 2003; 98:292-296.
31. Ratanatharathorn V, Flynn P, van Burik J, et al. Micafungin in combination with systemic antifungal agents in the treatment of refractory aspergillosis in bone marrow transplant patients. Philadelphia, PA: Abstracts of the 2002 American Society of Hematology Annual Meeting; 2002. Abstract # 2742.
32. Spellberg B, Fu Y, Edwards JE Jr, Ibrahim AS. Combination therapy with amphotericin B lipid complex and caspofungin acetate of disseminated zygomycosis in diabetic ketoacidotic mice. Antimicrob Agents Chemother 2005; 49:830-832.
33. Vazquez L, Mateos JJ, Sanz-Rondriguez C, et al. Successful treatment of rhinocerebral zygomycosis with a combination of caspofungin and liposomal amphotericin b. Haematologica 2005; 90:ECR39.
34. Torres HA, Hachem RY, Chemaly RF, et al. Posaconazole: a broad-spectrum triazole antifungal. Lancet Infect Dis 2005; 5:775-785.
35. Maertens J, Theunissen K, Verhoef G, et al. Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high-risk for invasive fungal infection: a prospective feasibility study. Clin Infect Dis 2005; 41:1242-1250.