Duration of systemic antifungal therapy for patients with invasive fungal diseases: A reassessment.

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Tác giả: Thierry Calandra, Simon B Gressens, Frederic Lamoth, Fanny Lanternier, Olivier Lortholary, Claire Rouzaud

Ngôn ngữ: eng

Ký hiệu phân loại: 635.62 *Squashes and pumpkins

Thông tin xuất bản: England : Molecular aspects of medicine , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 713268

Invasive fungal diseases are associated with significant morbidity and mortality, especially among immunocompromised patients, and often prompt for rapid and aggressive treatment aiming cure. Due to the expanding magnitude of patients burdened by chronic immunosuppression and affected by fungal diseases, the diversity of clinical settings has risen. This often results in prolonged therapy (induction, consolidation and maintenance) associated with potentially severe side effects, and clinicians face the challenging decisions of when and how to stop anti-fungal therapy. Adequate duration of therapy is poorly defined, hampered by the lack of dedicated trials to the question, the heterogeneity of cases (type of fungal pathogen, localization of infection, underlying host conditions) and various confounding factors that may influence the clinical response (e.g. persistence vs recovery of immunosuppression, impact of surgery). In this review, we aim to evaluate the existing data underlying the guidelines and recommendations of treatment duration for the most frequent invasive fungal diseases (cryptococcal meningitis, Pneumocystis pneumonia, invasive aspergillosis, invasive candidiasis and mucormycosis), as well as specific localizations of deep-seated diseases (osteo-articular or central nervous system diseases and endocarditis) and emerging considerations and strategies.
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