EL LARGO CAMINO HACIA EL ANTIFUNGICO IDEAL

(especial para SIIC © Derechos reservados)
El tratamiento de las infecciones fúngicas está limitado por problemas de seguridad de los fármacos empleados, así como por su perfil de resistencia y efectividad.
Autor:
Alfonso javier Carrillo-muñoz
Columnista Experto de SIIC

Institución:
ACIA


Artículos publicados por Alfonso javier Carrillo-muñoz
Coautores
Cristina Tur-Tur* Juan Manuel Hernández-Molina** Guillermo Quindós Andrés*** Gustavo Giusiano**** 
SDPI CAP MANSO, Barcelona, España*
Hospital Carlos Haya, Málaga, España**
Universidad del País Vasco, Bilbao, España***
Universidad Nacional del Nordeste, Resistencia, Argentina****
Recepción del artículo
31 de Julio, 2008
Aprobación
18 de Septiembre, 2008
Primera edición
30 de Abril, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Los diferentes tipos de micosis, especialmente las invasivas, constituyen un importante problema de salud pública puesto que su incidencia se ha incrementado dramáticamente en las últimas décadas con relación al sida, trasplantes, enfermedades hematológicas e inmunosupresiones. El tratamiento de las infecciones fúngicas está limitado por problemas de seguridad de los fármacos empleados, así como por su perfil de resistencia y efectividad. Las terapias actuales para el tratamiento de las micosis invasivas sólo abarcan un reducido número de antifúngicos como la anfotericina B, el fluconazol y el itraconazol. Otros nuevos agentes de nueva generación y también de familias químicas ya empleadas, como voriconazol, posaconazol, ravuconazol, caspofungina, anidulafungina o micafungina han sido introducidas para el tratamiento de las infecciones fúngicas. Esta revisión se centra en el mecanismo de acción de estos antifúngicos frente a levaduras patógenas. Se han explorado nuevas dianas de acción para tratar de evitar los problemas derivados del uso de azoles, macrólidos y equinocandinas. Con ello, se han propuesto y desarrollado algunas nuevas sustancias.

Palabras clave
antifúngicos, mecanismo de acción, anfotericina B, azoles, alilaminas, equinocandinas


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Abstract
Different kinds of mycoses, especially invasive, have become an important public health problem as their incidence has increased dramatically in the last decades related with AIDS, transplant recipients, haematological malignancies and other immunosuppressed individuals. Management of fungal infections is markedly limited by problems of drug safety, resistance and effectiveness profile. Current therapy for invasive mycoses uses a relative reduced number of antifungal drugs, such as amphotericin B, fluconazole and itraconazole. Other new antifungal agents, from old and new chemical families, like voriconazole, posaconazole, ravuconazole, caspofungin or micafungin are been introduced in the armamentarium for fungal infections management. This review is focused in mode of action of those antifungal drugs used against pathogenic yeasts. Novel targets were explored trying to overcome the problems derived from the exploitation of azole drugs, macrolides and echinocandins. Proposed antifungal drugs have been developed against potential targets.

Key words
antifungal drugs, mode of action, amphotericin B, azole antifungals, allylamines, echinocandins


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Infectología
Relacionadas: Farmacología, Medicina Farmacéutica, Medicina Interna



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Enviar correspondencia a:
Alfonso Javier Carrillo-Muñoz, ACIA Departamento de Microbiología, E-08080, P.O. Box 10178, Barcelona, España
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