Treatment of systemic fungal infections in older patients: achieving optimal outcomes.

Abstract:

:Systemic fungal infections are an increasing problem in older adults. For several of the endemic mycoses, this increase is the result of increased travel and leisure activities in areas endemic for these fungi. Immunosuppressive agents, care in an intensive care unit, and invasive devices all contribute to infection with opportunistic fungi. Treatment of systemic fungal infections is usually with an azole or amphotericin B. The preferred regimen depends on the specific fungal infection, the site and the severity of the infection, the state of immunosuppression of the patient and the possible toxicities of each drug for a specific patient. In older adults, drug-drug interactions between the azoles and drugs commonly prescribed for older persons may lead to serious toxicity, and absorption of itraconazole can be problematic. Amphotericin B is associated with significant nephrotoxicity, especially in older adults with pre-existing renal disease, and infusion-related adverse effects. Newer lipid formulations of amphotericin B can obviate some of these toxicities, but their role in the treatment of systemic fungal infections in older adults has not yet been clarified.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Kauffman CA,Hedderwick SA

doi

10.2165/00002512-200118050-00002

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

313-23

issue

5

eissn

1170-229X

issn

1179-1969

journal_volume

18

pub_type

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