Ellsworth Misti, Ostrosky-Zeichner Luis
Division of Pediatric Infectious Diseases, UT Health McGovern Medical School, Houston, TX 77030, USA.
Division of Infectious Diseases, UT Health McGovern Medical School, Houston, TX 77030, USA.
J Fungi (Basel). 2020 Nov 29;6(4):324. doi: 10.3390/jof6040324.
Increasing incidence of invasive fungal infections combined with a growing population of immunocompromised hosts has created a rising need for antifungal agents. Isavuconazole, a second-generation broad-spectrum triazole with activity against yeasts, dimorphic fungi, and molds, has a favorable safety profile and predictable pharmacokinetics. Patients typically tolerate isavuconazole well with fewer drug-drug interactions. Clinical trials have found it to be noninferior to voriconazole for invasive aspergillosis, an alternative therapy for salvage treatment of mucormycosis, and suitable for stepdown therapy with invasive candidiasis. Cross-resistance with other triazoles is common. More studies are needed to determine the role of isavuconazole in anti-mold prophylaxis in high-risk patients.
侵袭性真菌感染发病率的上升，加之免疫功能低下宿主群体的不断增加，使得对抗真菌药物的需求日益增长。艾沙康唑是一种第二代广谱三唑类药物，对酵母、双相真菌和霉菌均有活性，具有良好的安全性和可预测的药代动力学。患者通常对艾沙康唑耐受性良好，药物相互作用较少。临床试验发现，对于侵袭性曲霉病，它不劣于伏立康唑，是毛霉病挽救治疗的替代疗法，也适用于侵袭性念珠菌病的降阶梯治疗。与其他三唑类药物的交叉耐药很常见。需要更多研究来确定艾沙康唑在高危患者抗霉菌预防中的作用。
