CRC ANTIFUNG THER PDF

Preface

This book is designed to provide a comprehensive but insightful examination of antifungal therapy in the changing clinic millenium of modern medicine. It is clear that as medicine advances to treat and cure severe underlying diseases, the collateral consequences of this management can be immunosuppression and opportunistic fungal infections. Furthermore, there are a series of primary fungal infections such as dermatophytosis and endemic mycoses which continue to plague normal hosts. Furthermore, the pandemic of HIV which has impacted the entire world laid in its immunosuppressive path the rise of invasive mycoses. It is clear that most clinicians who care for the seriously sick will be faced at times with the appearance of a fungal infection and a need to manage its disease. There are many aspects of invasive mycoses including genetic susceptibility, risk factor predictions, diagnosis, epidemiology and outcome of underlying diseases which require a present and future knowledge base for medical practice. In this book, we have attempted to focus the presentation on the management aspect of fungal disease.With the rising number of fungal infections world wide and the development and clinical use of a variety of antifungal agents, it is quite clear that the statement: "Amphotericin B is the gold standard for the invasive mycoses" is no longer true.We have safer and effective alternative drugs to use. It is our mission in this book to provide clinicians with a foundation and insights into current antifungal management.

There are four sections in this book. First, we approach some general antifungal agent issues from the history of antifungal, fungal epidemiology, antifungal agent preclinical development to drug resistance. Second, we examine in depth the antifungal classes of drugs, Third, there is an attempt to provide clinical management issues and strategies around specific fungal infections in which the clinician may face frequently or rarely depending on the patient population in their practice. In these sections there are insights provided into dosing, choice of drugs, concerns about complications and outcome which are both evidence—based but mixed with personal opinions and experiences. Fungal infections are treated "one patient at a time" and there is no "cookbook recipe" that fits all patients all the time. In fact, the underlying disease simply gets in the way too often or our evidence-based material is either weak or non-existent. Finally, we conclude with management of several risk groups or unique patient populations or infection sites and their fungal infections. It is not an exhaustive list but provides illustrative exposure to these patients but also lays the ground work/foundation for the principles of managing other risk groups which occur today or may occur tomorrow.

Fungal diseases have risen to prominence over the last 50 years. They have paralleled the technological advances in the care of serious medical diseases. Fungi, as eukaryotic organisms, play an interesting role in the human condition. They have been harnessed to help make our bread and beverages. In fact, we eat some of them and during the traffic of life, we are constantly exposed to millions of them. During health they are rarely a problem for us and after death they degrade us. Many of our critical exposures for health and fungi come between these stations of life. It is in this arena as a "human petri dish" that fungal disease raises its ugly consequences. It is the hope of these authors that this book reveals the tools, strategies, and insights to manage these irritating, costly and life-threatening infections. At times, it may seem the patient is defenseless against these mauraders but in fact, present antifungal therapy is very good and applied early and correctly can make a difference in patient outcome. This success story is told in the following pages.