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Current Fungal Infection Reports
Published in: Current Fungal Infection Reports 2/2020

01-06-2020 | Amphotericin B | Pharmacology and Pharmacodynamics of Antifungal Agents (J Amsden, Section Editor)

Updates in the Treatment of Breakthrough Mold Infections

Authors: Kellie J. Goodlet, Kelsey Spadafora, Rajat Walia, Michael D. Nailor

Published in: Current Fungal Infection Reports | Issue 2/2020

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Abstract

Purpose of Review

Patients on antifungal therapy who develop breakthrough mold infections pose significant treatment challenges for clinicians. Treatment of these infections demands a multimodal approach, including a thorough patient assessment, immune restoration, and evaluation for nonadherence and drug–drug interactions. However, limited clinical trial data are available to guide therapeutic decision-making.

Recent Findings

Organisms associated with breakthrough mold infection have historically included Aspergillus species and the Mucorales; however, rare and resistant molds are increasing in prevalence. Treatment failure and mortality rates remain high with breakthrough infection, irrespective of the selected treatment. Therapeutic drug monitoring, dose optimization, and combination antifungal therapy have been increasingly used to treat refractory cases.

Summary

Switch therapy and combination antifungal therapy represent the major treatment strategies for breakthrough mold infection. Herein, preclinical and clinical data are reviewed supporting the merits of each approach. Additionally, recommendations for therapeutic drug monitoring are provided.
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Metadata
Title
Updates in the Treatment of Breakthrough Mold Infections
Authors
Kellie J. Goodlet
Kelsey Spadafora
Rajat Walia
Michael D. Nailor
Publication date
01-06-2020
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 2/2020
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-020-00387-2

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Azole-Resistant Aspergillus and Echinocandin-Resistant Candida: What Are the Treatment Options?

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Combat Trauma–Related Invasive Fungal Wound Infections

Advances in Diagnosis of Invasive Fungal Infections (O Morrissey, Section Editor)

Diagnosis of Invasive Aspergillosis in Intensive Care Unit Patients

Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz and M Pereira, Section Editors)

Skin Infections Caused by Emerging Candida Species

Pharmacology and Pharmacodynamics of Antifungal Agents (J Amsden, Section Editor)

Antifungal and Oral Anticancer Therapy Drug Interactions
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