Related resources
Search for item elsewhere
University researcher(s)
Academic department(s)
International expert opinion on the management of azole resistance in Aspergillus fumigatus
Paul E Verweij, MD; Michelle Ananda-Rajah, MD; David Andes, MD; Maiken C Arendrup, MD; Roger BrĂĽggemann, PharmD; Arundha Chowdhary, MD; Oliver Cornely, MD; David W Denning, MD; Andreas Groll, MD; Koichi Izumikawa, MD; Bart Jan Kullberg, MD; Katrien Lagrou, PharmD; Johan Maertens, MD; Jacques FGM Meis, MD; Pippa Newton, MD; Iain Page, MD; Seyedmojtaba SeyedmousaviTasieh, VMD; Don Sheppard, MD; Claudio Viscoli, MD; Adilia Warris, MD; and J Peter Donnelly, PhD
Access to files
Full-text and supplementary files are not available from Manchester eScholar. Use our list of Related resources to find this item elsewhere. Alternatively, request a copy from the Library's Document supply service.
Abstract
In the absence of treatment recommendations, an international expert meeting was held to discuss the management of azole-resistant aspergillosis. In vitro susceptibility testing should always be performed if antifungal therapy has been initiated and the culture is positive. In azole-resistant invasive pulmonary aspergillosis the experts would switch treatment from voriconazole to liposomal amphotericin B (L-AmB). In regions with a resistance rate due to environmental resistance mechanisms of >10%, the majority of experts favoured L-AmB as initial therapy, with a minority favouring voriconazole combined with an echinocandin. All experts would use L-AmB as core therapy for suspected azole-resistant aspergillosis of the central nervous system, and would consider the addition of a second agent; the majority favouring flucytosine. In pan-azole resistant chronic pulmonary aspergillosis, intravenous therapy with a non-azole agent is the only therapeutic option. Surveillance, a case registry, improved diagnostics and greater understanding of resistance selection in the environment are areas where researched is urgently needed, in addition to the development of new oral agents. (164).