44
silver) with fungal cultures are essential for the deep diagnosis of sinusitis and its
subclassification (Kim et al. 2012). Polymerase chain reaction (PCR) detects the
genus/species of fungus in >70% of chronic rhinosinusitis (Kim et al. 2005), and
cultures from tissue samples provide positive reports in 30–70% of cases of chronic
fungal rhinosinusitis (Chakrabarti 2009; Challa 2010).
3.5 Treatment of Aspergillosis
With overall 200,000 known fungal species, only a few percentage have been
described to be associated with human illness and diseases (Denning 1996). The
mortality rate of invasive aspergillosis is compensated with the use of antifungal
treatments; attainment of complete cure from the treatment is highly dependent on
time of diagnosis, the type of invasive aspergillosis, and the immune response of the
particular patient (Latge 2001). Since 1990, itraconazole and amphotericin B are the
two important antifungal drugs used commonly for invasive aspergillosis (Denning
2006; Nascimento et al. 2003). Initially itraconazole was given to the patients whose
body cannot tolerate amphotericin B. The kind of azole drugs, including itraconazole, inhibits the cytochrome p-450 which is involving in the ergosterol biosynthesis. Ergosterol is sterol which aids the formation of a significant element of the
fungal cellular membrane (Nascimento et al. 2003).
Several allergic aspergilloses such as ABPA or allergic Aspergillus sinusitis, the
commonly suggested antifungal drug is itraconazole; corticosteroids are also
optionally used (Ng et al. 1994). In recent days, the newer and most effective voriconazole (Vfend) is used as standard antifungal drug for invasive aspergillosis
(Tkacz and DiDomenico 2001). Amphotericin B also used in some cases as an
optional medication.
IA in patients is treated with antifungal drugs such as voriconazole. After the
approval of voriconazole in the United States in 2002 for clinical use, it has been
used as an antifungal agent. Voriconazole is more effective against itraconazoleresistant strains of A. fumigatus (Arikan et al. 1994). The antifungal medications
such as lipid amphotericin formulations, isavuconazole, posaconazole, itraconazole,
micafungin, and caspofungin are employed to treat aspergillosis. People who are
severely affected with aspergillosis may be treated by surgery. In the case of immunocompromised adults with invasive aspergillosis, caspofungin drug is given
optionally to the patients who did not respond to tolerate other antifungal drugs. The
new treatments and techniques against aspergillosis lead to the improved drug therapy and antifungal research, but many of the drug targets are yet to be studied. The
development of new therapeutics needs to reduce the mortality and improve the
survival rate of the patients with invasive aspergillosis.
S. Jayapalan et al.
silver) with fungal cultures are essential for the deep diagnosis of sinusitis and its
subclassification (Kim et al. 2012). Polymerase chain reaction (PCR) detects the
genus/species of fungus in >70% of chronic rhinosinusitis (Kim et al. 2005), and
cultures from tissue samples provide positive reports in 30–70% of cases of chronic
fungal rhinosinusitis (Chakrabarti 2009; Challa 2010).
3.5 Treatment of Aspergillosis
With overall 200,000 known fungal species, only a few percentage have been
described to be associated with human illness and diseases (Denning 1996). The
mortality rate of invasive aspergillosis is compensated with the use of antifungal
treatments; attainment of complete cure from the treatment is highly dependent on
time of diagnosis, the type of invasive aspergillosis, and the immune response of the
particular patient (Latge 2001). Since 1990, itraconazole and amphotericin B are the
two important antifungal drugs used commonly for invasive aspergillosis (Denning
2006; Nascimento et al. 2003). Initially itraconazole was given to the patients whose
body cannot tolerate amphotericin B. The kind of azole drugs, including itraconazole, inhibits the cytochrome p-450 which is involving in the ergosterol biosynthesis. Ergosterol is sterol which aids the formation of a significant element of the
fungal cellular membrane (Nascimento et al. 2003).
Several allergic aspergilloses such as ABPA or allergic Aspergillus sinusitis, the
commonly suggested antifungal drug is itraconazole; corticosteroids are also
optionally used (Ng et al. 1994). In recent days, the newer and most effective voriconazole (Vfend) is used as standard antifungal drug for invasive aspergillosis
(Tkacz and DiDomenico 2001). Amphotericin B also used in some cases as an
optional medication.
IA in patients is treated with antifungal drugs such as voriconazole. After the
approval of voriconazole in the United States in 2002 for clinical use, it has been
used as an antifungal agent. Voriconazole is more effective against itraconazoleresistant strains of A. fumigatus (Arikan et al. 1994). The antifungal medications
such as lipid amphotericin formulations, isavuconazole, posaconazole, itraconazole,
micafungin, and caspofungin are employed to treat aspergillosis. People who are
severely affected with aspergillosis may be treated by surgery. In the case of immunocompromised adults with invasive aspergillosis, caspofungin drug is given
optionally to the patients who did not respond to tolerate other antifungal drugs. The
new treatments and techniques against aspergillosis lead to the improved drug therapy and antifungal research, but many of the drug targets are yet to be studied. The
development of new therapeutics needs to reduce the mortality and improve the
survival rate of the patients with invasive aspergillosis.
S. Jayapalan et al.