BACKGROUND Purpureocillium lilacinum(P.lilacinum)is a saprophytic fungus widespread in soil and vegetation.As a causative agent,it is very rarely detected in humans,most commonly in the skin.CASE SUMMARY In this artic...BACKGROUND Purpureocillium lilacinum(P.lilacinum)is a saprophytic fungus widespread in soil and vegetation.As a causative agent,it is very rarely detected in humans,most commonly in the skin.CASE SUMMARY In this article,we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever.Computed tomography revealed an infection in the right lower lobe.Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P.lilacinum.She was eventually discharged with good outcomes after treatment with isavuconazole.CONCLUSION Pulmonary infection with P.lilacinum was exceedingly rare.While currently there are no definitive therapeutic agents,there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles.The present report is the first known use of isavuconazole for pulmonary P.lilacinum infection.It provides new evidence for the characterization and treatment of clinical P.lilacinum lung infections.展开更多
<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:...<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:Verdana;">against </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">and </span><i><span style="font-family:Verdana;">Aspergillus spp. </span></i><span style="font-family:Verdana;">by Mo</span></span><span style="font-family:Verdana;">n</span><span style="font-family:Verdana;">te Carlo simulation (MSC). Pharmacokinetic parameters and microbiological data of Isavuconazole were collected. Then we used MSC to simulate 10,000 patients analyzed by Crystal Ball to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR). With dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 400</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in oral group and dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in intravenous administration, all have different degree</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of antifungal effect. But when the dosage regimen was 50</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">mg IV, the therapeutic effect of Isavuconazole against </span><i><span style="font-family:Verdana;">Aspergillus spp.</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">were not good.展开更多
目的:评价艾沙康唑(ISA)治疗侵袭性真菌感染(IFI)的疗效和安全性,为临床治疗策略的选择提供循证依据。方法:检索Embase、PubMed、Web of Science、the Cochrane Library、维普数据库、中国知网、万方数据库和中国生物医学文献服务系统等...目的:评价艾沙康唑(ISA)治疗侵袭性真菌感染(IFI)的疗效和安全性,为临床治疗策略的选择提供循证依据。方法:检索Embase、PubMed、Web of Science、the Cochrane Library、维普数据库、中国知网、万方数据库和中国生物医学文献服务系统等,检索时限均为建库至2023年5月,获取ISA治疗IFI的随机对照试验(RCT)、队列研究和病例对照研究(观察组患者使用ISA单药治疗,对照组患者使用伏立康唑或两性霉素B单药治疗)。对纳入的文献进行质量评价、资料提取,应用RevMan 5.4.1软件进行Meta分析。结果:共纳入3项RCT、3项队列研究和1项病例对照研究,包括914例患者。Meta分析结果表明,观察组与对照组患者总有效率(RR=1.00,95%CI=0.84~1.17,P=0.96)、全因死亡率(RR=0.95,95%CI=0.76~1.18,P=0.62)的差异均无统计学意义。安全性方面,观察组患者的总体不良反应发生率低于对照组(RR=0.76,95%CI=0.58~0.99,P=0.05);其中视觉异常(RR=0.47,95%CI=0.34~0.67,P<0.0001)、肝功能损伤(RR=0.56,95%CI=0.38~0.83,P=0.004)的发生率明显低于对照组,差异有统计学意义;但两组患者神经系统不良反应发生率的差异无统计学意义(RR=1.04,95%CI=0.83~1.31,P=0.71)。结论:ISA治疗IFI的疗效与伏立康唑相近,整体安全性优于伏立康唑,尤其是肝功能损伤、视觉异常的发生率低于伏立康唑,但临床应用过程中仍需要关注其神经系统不良反应。展开更多
目的 分析氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的药物不良反应(adverse drug reaction,ADR)特征。方法 在美国食品药品管理局公共数据开放项目(U.S.food and drug administration open public data project,openFDA)检索200...目的 分析氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的药物不良反应(adverse drug reaction,ADR)特征。方法 在美国食品药品管理局公共数据开放项目(U.S.food and drug administration open public data project,openFDA)检索2004-01-01—2021-03-31提交的关于氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的ADR报告,对年龄、性别、适应症、给药途径、常见ADR、严重药物不良反应、药物剂量调整及患者转归情况进行统计分析。结果 在openFDA数据库中有关氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的ADR报告数目分别为35 654,6 218,12 164,3 837和800例。发生ADR人群的年龄主要集中于19~64岁,主要是预防和治疗侵袭性真菌感染,此5种三唑类抗真菌药物给药途径通常为口服及静脉。发生的ADR涉及多个系统,主要表现为发热、恶心、腹泻及QT间期的变化等症状。结论 除了常见的ADR外,还发现氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑说明书中未提到的ADR,为临床中合理使用三唑类药物提供参考。展开更多
文摘BACKGROUND Purpureocillium lilacinum(P.lilacinum)is a saprophytic fungus widespread in soil and vegetation.As a causative agent,it is very rarely detected in humans,most commonly in the skin.CASE SUMMARY In this article,we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever.Computed tomography revealed an infection in the right lower lobe.Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P.lilacinum.She was eventually discharged with good outcomes after treatment with isavuconazole.CONCLUSION Pulmonary infection with P.lilacinum was exceedingly rare.While currently there are no definitive therapeutic agents,there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles.The present report is the first known use of isavuconazole for pulmonary P.lilacinum infection.It provides new evidence for the characterization and treatment of clinical P.lilacinum lung infections.
文摘<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:Verdana;">against </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">and </span><i><span style="font-family:Verdana;">Aspergillus spp. </span></i><span style="font-family:Verdana;">by Mo</span></span><span style="font-family:Verdana;">n</span><span style="font-family:Verdana;">te Carlo simulation (MSC). Pharmacokinetic parameters and microbiological data of Isavuconazole were collected. Then we used MSC to simulate 10,000 patients analyzed by Crystal Ball to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR). With dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 400</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in oral group and dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in intravenous administration, all have different degree</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of antifungal effect. But when the dosage regimen was 50</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">mg IV, the therapeutic effect of Isavuconazole against </span><i><span style="font-family:Verdana;">Aspergillus spp.</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">were not good.
文摘目的 分析氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的药物不良反应(adverse drug reaction,ADR)特征。方法 在美国食品药品管理局公共数据开放项目(U.S.food and drug administration open public data project,openFDA)检索2004-01-01—2021-03-31提交的关于氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的ADR报告,对年龄、性别、适应症、给药途径、常见ADR、严重药物不良反应、药物剂量调整及患者转归情况进行统计分析。结果 在openFDA数据库中有关氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑的ADR报告数目分别为35 654,6 218,12 164,3 837和800例。发生ADR人群的年龄主要集中于19~64岁,主要是预防和治疗侵袭性真菌感染,此5种三唑类抗真菌药物给药途径通常为口服及静脉。发生的ADR涉及多个系统,主要表现为发热、恶心、腹泻及QT间期的变化等症状。结论 除了常见的ADR外,还发现氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑说明书中未提到的ADR,为临床中合理使用三唑类药物提供参考。
