Subject(s)
Guidelines as Topic , Immunization Programs/standards , Vaccination/standards , Adolescent , Adult , Bacterial Vaccines/administration & dosage , Child , Child, Preschool , Female , Forecasting , Humans , Immunization Programs/trends , Male , North Carolina , Vaccination/trends , Viral Vaccines/administration & dosageABSTRACT
Invasive fungal infections are seen with growing frequency, likely due to increases in numbers of patients at risk of infection. Optimal selection and dosing of antifungal agents are important, as these infections are often refractory to available therapy. In contrast to antibacterials, studies examining the pharmacodynamic properties of antifungals and their application in treating invasive disease often are lacking. Agents administered for invasive infections are amphotericin B, flucytosine, and azole antifungals. Several drugs are under investigation, such as posiconazole, voriconazole, and the echinocandins, and preliminary pharmacodynamic data likely will help shape dosing regimens. Clinical trials that investigated dosage and administration, as well as the potential benefits of combination and sequential therapy, are addressed. In addition, antifungal susceptibility and animal models of infection are discussed.
Subject(s)
Antifungal Agents , Fungi/drug effects , Mycoses/drug therapy , Animals , Antifungal Agents/blood , Antifungal Agents/pharmacokinetics , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Area Under Curve , Biological Availability , Disease Models, Animal , Half-Life , Humans , Metabolic Clearance Rate , Microbial Sensitivity TestsABSTRACT
While waiting to observe the response to ibutilide fumarate by a patient with atrial fibrillation, a nurse preparing the intravenous solution inadvertently spilled the drug on the hands of a medical resident. The resident immediately wiped his hands dry with disposable paper towels. Several hours later he sensed tingling and itching over the area, and the next day two erythematous bullous lesions were present on the dorsal surfaces of both hands. A single application of topical steroid was applied to the affected areas. The lesions were kept clean and dry, and healed completely in approximately 10 days. This is an unusual allergic reaction due to contact with ibutilide fumarate.