Forrister Nicholas M, McCarty Todd P, Pappas Peter G
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.
Antimicrob Agents Chemother. 2025 Jan 31;69(1):e0064623. doi: 10.1128/aac.00646-23. Epub 2024 Dec 12.
Candidemia and invasive candidiasis persist as significant causes of morbidity and mortality. As fluconazole resistance rates rise, alternative means of treatment are necessary, either via mold-active azoles or extended durations of echinocandins. These come with the potential for undesirable side effects for triazoles or choosing between prolonged hospitalization or outpatient parenteral antimicrobial therapy in the case of echinocandins. Rezafungin offers an opportunity to manage extended treatment durations with shorter hospital stays and no extended parenteral access. Herein, we review the most recent published data pertaining to rezafungin including anti-fungal activity, pharmacokinetics, and clinical data relating to the treatment of invasive candidiasis. Given its prolonged half-life allowing for once-weekly dosing, rezafungin has the potential as an anti-fungal prophylactic agent in high-risk patients, and studies to examine this potential role are ongoing.
念珠菌血症和侵袭性念珠菌病仍然是发病和死亡的重要原因。随着氟康唑耐药率的上升,需要通过使用对霉菌有活性的唑类药物或延长棘白菌素的使用时间等替代治疗方法。这些方法可能会带来三唑类药物的不良副作用,或者在棘白菌素治疗的情况下,需要在延长住院时间或门诊胃肠外抗菌治疗之间进行选择。瑞扎芬净提供了一个机会,可以在缩短住院时间且无需长期胃肠外给药的情况下进行延长治疗。在此,我们回顾了与瑞扎芬净相关的最新发表数据,包括抗真菌活性、药代动力学以及与侵袭性念珠菌病治疗相关的临床数据。鉴于其半衰期长,允许每周给药一次,瑞扎芬净有潜力作为高危患者的抗真菌预防药物,目前正在进行研究以检验这一潜在作用。