Toxicidad hematológica durante el tratamiento con albendazol / Haematological toxicity during treatment with albendazole

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[Differential pharmacokinetic characteristics of micafungin. Experience in special populations]. / Características farmacocinéticas diferenciales de micafungina. Experiencia en poblaciones especiales.

Currently, three echinocandins are available for the treatment of fungal infections. Micafungin is the latest drug to be incorporated into this group of antifungal agents. Although the mechanism of action of micafungin is similar to that of other echinocandins, this molecule has certain pharmacokinetic characteristics that distinguish it from other drugs in this group. Nowadays, there is wide information on the pharmacokinetic behavior of micafungin, mainly from patients included in clinical trials. However, there is far less knowledge of the pharmacokinetics of this echinocandin in special populations. The aim of the current review was to analyze the available information on the pharmacokinetics of micafungin in pediatric patients, the elderly, patients with renal insufficiency or liver failure, and transplant recipient.

[Pharmacoeconomics of therapy in invasive candidiasis]. / Farmacoeconomía del tratamiento de las candidiasis invasoras.

BACKGROUND: Invasive candidiasis episodes have increased during last years and they have been related with high rates of crude mortality. Invasive candidiasis-related deaths have not diminished significantly with the introduction of antifungals in the past decade. Finantial managers are worried about extra costs from acquisition of new antifungal agents. AIM: This review includes the main studies age-stratified to assess different variables related to the economic burden of invasive candidiasis. METHODS: Systematic review of biomedic databases including Medline, PubMed and EMBASE. RESULTS: The studies show hospital stay as the main variable related with higher impact in the increase of invasive candidiasis costs. Acquisition costs of antifungals have a very low impact in the invasive candidiasis costs. CONCLUSIONS: Pharmacoeconomics applied in candidiasis invasive therapy must avoid assessing acquisition costs of antifungals exclusively, needing to include both direct and indirect costs associated with this fungal infection. The cost of antifungal acquisition represents a low impact in the overall economic burden of this fungal infection. Further pharmacoeconomics evaluations should be performed including similar definitions to decrease the possible bias in results interpretation.

Farmacoeconomía del tratamiento de las candidiasis invasoras / Pharmacoeconomics of therapy in invasive candidiasis

Antecedentes: Con los años, los episodios de candidiasis invasora se han incrementado y se han asociado con ratios elevados de mortalidad bruta. Los antifúngicos introducidos durante la pasada década no han producido una disminución significativa de la mortalidad relacionada con esta enfermedad infecciosa. Los costes de adquisición de los antifúngicos suponen una gran preocupación en la gestión de los costes de farmacia. Objetivos: Desarrollar una revisión de los principales estudios efectuados, estratificados por grupos de edad, para evaluar las distintas variables que afectan a la carga económica, así como los costes ocasionados por la candidiasis invasora. Métodos: Búsqueda sistemática de bases de datos Medline, PubMed y EMBASE. Resultados: Los estudios efectuados en pacientes con candidiasis invasora muestran que la estancia hospitalaria es la variable con más impacto en el incremento de los costes relacionados con esta infección fúngica. El coste de adquisición de los antifúngicos representa un porcentaje muy inferior al de otras variables analizadas. Conclusiones: El análisis farmacoeconómico de la candidiasis invasora requiere la inclusión del estudio de los costes directos e indirectos que lleva asociados, y no tan sólo, el de los costes de adquisición de los antifúngicos. Estos últimos representan una pequeña parte del coste total de esta enfermedad. Es preciso efectuar nuevos análisis farmacoeconómicos que unifiquen las definiciones utilizadas en los estudios con el fin de disminuir su impacto en la interpretación de los resultados (AU)

Background: Invasive candidiasis episodes have increased during last years and they have been related with high rates of crude mortality. Invasive candidiasis-related deaths have not diminished significantly with the introduction of antifungals in the past decade. Finantial managers are worried about extra costs from acquisition of new antifungal agents. Aim: This review includes the main studies agestratified to assess different variables related to the economic burden of invasive candidiasis. Methods: Systematic review of biomedic databases including Medline, PubMed and EMBASE. Results: The studies show hospital stay as the main variable related with higher impact in the increase of invasive candidiasis costs. Acquisition costs of antifungals have a very low impact in the invasive candidiasis costs. Conclusions: Pharmacoeconomics applied in candidiasis invasive therapy must avoid assessing acquisition costs of antifungals exclusively, needing to include both direct and indirect costs associated with this fungal infection. The cost of antifungal acquisition represents a low impact in the overall economic burden of this fungal infection. Further pharmacoeconomics evaluations should be performed including similar definitions to decrease the possible bias in results interpretation (AU)