therapeutic drug monitoring

When Nature Meets Oncology: Unraveling Herb–Drug Interactions in Cancer Therapy

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Many cancer patients use herbal supplements and natural products alongside their cancer treatments without telling their doctors, which can be dangerous. Some natural products like St. John’s Wort and grapefruit juice significantly alter how the body processes cancer medications, potentially making treatments ineffective or toxic. The review provides guidance on which natural products are safe to use with cancer therapy and which should be avoided completely, emphasizing the importance of open communication between patients and healthcare providers.

A case report of disseminated histoplasmosis not responding to primary treatment by itraconazole

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A 28-year-old woman developed a fungal infection called histoplasmosis after having a tooth extracted, with the infection spreading to her lungs and sinuses. She was initially given a common antifungal medication called itraconazole, but her condition continued to worsen despite increasing the dose. When doctors switched her to a stronger medication called liposomal amphotericin B given intravenously, she improved dramatically and recovered fully. This case shows the importance of recognizing when a standard fungal treatment is not working and switching to more aggressive therapy.

Fungal Pneumonia and Severe Neutropenia: Risk Factors for Increased 90 Day Mortality

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This study examined 39 cancer patients with severe fungal lung infections treated at a major cancer center. Patients who received antifungal treatment within 7 days and started with a specific drug called liposomal amphotericin B had better survival rates at 90 days. The research suggests that quick diagnosis and prompt treatment initiation are critical for improving survival in immunocompromised patients with fungal pneumonia.

Peritoneal dialysis-related peritonitis caused by Fusarium: a case report and literature review

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A 61-year-old farmer on peritoneal dialysis developed a rare fungal infection caused by Fusarium after antibiotics failed to treat her peritonitis. Pharmacists helped doctors switch her to the antifungal medication voriconazole and carefully monitored blood levels to ensure the dose was high enough. After adjusting the dose based on blood tests, the patient recovered completely with no symptoms and normal test results within two months.

Refractory fungal infection: Three case reports highlighting good practice

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This case series examines three patients with serious fungal infections that did not respond well to standard antifungal treatments. The cases demonstrate how fungi can develop resistance to common antifungal drugs like azoles, making infections harder to treat. The authors emphasize that accurate identification of the fungus, testing its sensitivity to drugs, monitoring drug levels in the blood, and careful use of antifungal medications are essential for successfully treating these difficult infections.

Clinical aspects and recent advances in fungal diseases impacting human health

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Fungal infections are increasingly common health threats affecting over a billion people worldwide, ranging from minor allergies to serious life-threatening infections. The biggest problems are that fungi are becoming resistant to current medications, diagnosis can be difficult and slow, and treatment options are limited. Recent developments include new antifungal drugs like ibrexafungerp and rezafungin that work differently from older medications, offering hope for treating resistant infections. Better awareness among doctors and patients, faster diagnostic methods, and responsible use of antifungals are essential to combat this growing public health challenge.

Neosartorya udagawae pulmonary infection requiring a surgical treatment in a paediatric haematopoietic progenitor cell recipient

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A three-year-old boy with leukemia received a bone marrow transplant and developed a serious fungal lung infection caused by Neosartorya udagawae, a rare fungal pathogen. Despite receiving multiple antifungal medications at appropriate doses, the infection continued to worsen and spread in his lungs. Doctors ultimately had to surgically remove the infected portion of his lung (left upper lobe) to successfully treat the infection, and the child recovered completely without recurrence after three years of follow-up.

Breakthrough Invasive Mould Infections Under Posaconazole Prophylaxis in Patients With Haematologic Malignancies: A Case–Control Study

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This study examined cases where patients receiving posaconazole to prevent fungal infections still developed serious mould infections despite the medication. Researchers compared 29 patients who developed these breakthrough infections with 46 control patients who did not. They found that over half of patients with breakthrough infections died, compared to only 20% of controls, and that surgical treatment significantly improved survival for certain types of fungal infections.

Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland

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This study examined how 62 children’s cancer hospitals in Germany, Austria and Switzerland manage fungal infections in young cancer patients. Researchers found that hospitals use different methods to prevent and treat these serious infections, with some having special fungal infection experts and others not. The study revealed that larger hospitals tend to have better resources and expertise, while smaller hospitals face challenges like drug interactions and delays in getting test results.

ESCMID-EFISG Survey on Diagnostic and Therapeutic Capacity for Invasive Fungal Infections in Belgium, the Netherlands, and Luxembourg: A Focus on High Azole Resistance

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This survey examined how well hospitals in Belgium, the Netherlands, and Luxembourg can diagnose and treat serious fungal infections, which are particularly dangerous for people with weakened immune systems. The researchers found that while most hospitals can test fungal samples, not all have access to all necessary diagnostic tools, especially tests for detecting resistant fungi and identifying fungal co-infections. Many hospitals outsource their testing to other facilities, which can delay diagnosis and treatment, and some hospitals lack access to all recommended antifungal medications.

Research Keyword: therapeutic drug monitoring