Can We Achieve Clinical Breakpoints for the Triazoles in Aspergillosis?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Juan Luis Rodriguez-Tudela & William Hope & Manuel Cuenca-Estrella & J. Peter Donnelly & Cornelia Lass-Flِrl & Maiken C. Arendrup
- چاپ و سال / کشور: 2011
Description
The azoles are first-line agents for the treatment of aspergillosis. A number of recent studies have shown increasing rates of resistance in A. fumigatus. Consequently, reliable in vitro susceptibility testing and breakpoints that appropriately classify resistant isolates are of paramount importance. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical Laboratory Standards Institute (CLSI) have developed susceptibility testing standards, but so far no breakpoints have been defined. The following aspects are evaluated during the process of developing EUCAST breakpoints: the most common dosage, the definition of the wild-type population and epidemiologic cutoff values, pharmacokinetic and pharmacodynamic properties, and the correlation between the minimum inhibitory concentration (MIC) and clinical outcome. This article reviews the issues to be considered before breakpoints can be established for azole drugs and Aspergillus and describes how MICs can be interpreted until clinical breakpoints have been defined.
Curr Fungal Infect Rep (2011) 5:128–134 DOI 10.1007/s12281-011-0058-6 Published online: 2 June 2011
