Document Detail


Fungicidal versus Fungistatic: what's in a word?
MedLine Citation:
PMID:  18377336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Historically clinicians have preferred to use 'cidal' antifungal agents, particularly in critically ill patients. However, data to support the belief that the preferential use of a 'cidal' agent results in better patient outcomes has been lacking. OBJECTIVE: This review examined the in vitro definitions of fungicidal and fungistatic as well as their strengths and limitations. METHODS: A Medline search was performed in order to identify literature that examined the in vitro or in vivo impact of fungicidal and fungistatic activity. The study examined three common invasive fungal infections, namely cryptococcal meningitis, candidemia and invasive aspergillosis, where sufficient comparisons of fungicidal and fungistatic agents have been performed to allow for the evaluation of the clinical importance of these in vitro findings. RESULTS AND CONCLUSION: A clear clinical benefit of fungicidal agents over those with fungistatic activity remains elusive. Patients with cryptococcal meningitis clearly benefit from early fungicidal therapy but require long-term suppression. The data in invasive Candida sp. infections are tantalizing and suggest that fungicidal therapy may be important. However, the data for invasive aspergillosis do not support the hypothesis that fungicidal activity improves outcomes.
Authors:
James S Lewis; John R Graybill
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  9     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-05-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  927-35     Citation Subset:  IM    
Affiliation:
University Health System, Department of Pharmacy, 4502 Medical Drive, San Antonio, TX 78229, USA. james.lewis@uhs-sa.com
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / pharmacology,  therapeutic use*
Aspergillosis / drug therapy*
Aspergillus / drug effects
Candida / drug effects
Candidiasis / drug therapy*
Clinical Trials as Topic
Cryptococcosis / drug therapy*
Cryptococcus / drug effects
Echinocandins / pharmacology,  therapeutic use
Humans
Meningitis, Cryptococcal / drug therapy
Microbiological Techniques
Polyenes / pharmacology,  therapeutic use
Triazoles / pharmacology,  therapeutic use
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Echinocandins; 0/Polyenes; 0/Triazoles

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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