scholarly journals Lessons from an Educational Invasive Fungal Disease Conference on Hospital Antifungal Stewardship Practices across the UK and Ireland

2021 ◽  
Vol 7 (10) ◽  
pp. 801
Author(s):  
Alida Fe Talento ◽  
Malcolm Qualie ◽  
Laura Cottom ◽  
Matthijs Backx ◽  
P. Lewis White
Keyword(s):  
At Risk ◽  
Treatment Strategies ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Diagnostic Tools ◽  
Optimal Time ◽  
Rapid Diagnostics ◽  
Antifungal Stewardship ◽  
Patients At Risk ◽  
The Uk

Invasive fungal disease (IFD) is a growing health burden. High mortality rates, increasing numbers of at-risk hosts, and a limited availability of rapid diagnostics and therapeutic options mean that patients are increasingly exposed to unnecessary antifungals. High rates of prescriptions promote patient exposure to undue toxicity and drive the emergence of resistance. Antifungal stewardship (AFS) aims to guide antifungal usage and reduce unnecessary exposure and antifungal consumption whilst maintaining or improving outcomes. Here, we examine several AFS approaches from hospitals across the UK and Ireland to demonstrate the benefits of AFS practices and support the broader implementation of AFS as both a necessary and achievable strategy. Since the accuracy and turnaround times (TATs) of diagnostic tools can impact treatment decisions, several AFS strategies have included the development and implementation of diagnostic-driven care pathways. AFS informed treatment strategies can help stratify patients on a risk basis ensuring the right patients receive antifungals at the optimal time. Using a multidisciplinary approach is also key due to the complexity of managing and treating patients at risk of IFD. Through knowledge sharing, such as The Gilead Antifungal Information Network (GAIN), we hope to drive practices that improve patient management and support the preservation of antifungals for future use.

scholarly journals Pharmacokinetics and safety results from the Phase 3 randomized, open-label, study of intravenous posaconazole in patients at risk of invasive fungal disease

2017 ◽  
Vol 72 (12) ◽  
pp. 3501-3501 ◽  
Author(s):  
Oliver A Cornely ◽  
Michael N Robertson ◽  
Shariq Haider ◽  
Andrew Grigg ◽  
Michelle Geddes ◽  
...  
Keyword(s):  
At Risk ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Open Label ◽  
Phase 3 ◽  
Open Label Study ◽  
Label Study ◽  
Patients At Risk

scholarly journals Pharmacokinetics and safety results from the Phase 3 randomized, open-label, study of intravenous posaconazole in patients at risk of invasive fungal disease

2017 ◽  
Vol 72 (12) ◽  
pp. 3406-3413 ◽  
Author(s):  
Oliver A Cornely ◽  
Michael N Robertson ◽  
Shariq Haider ◽  
Andrew Grigg ◽  
Michelle Geddes ◽  
...  
Keyword(s):  
At Risk ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Open Label ◽  
Phase 3 ◽  
Open Label Study ◽  
Label Study ◽  
Patients At Risk

scholarly journals Phase 3 pharmacokinetics and safety study of a posaconazole tablet formulation in patients at risk for invasive fungal disease

2015 ◽  
Vol 71 (3) ◽  
pp. 718-726 ◽  
Author(s):  
Oliver A. Cornely ◽  
Rafael F. Duarte ◽  
Shariq Haider ◽  
Pranatharthi Chandrasekar ◽  
David Helfgott ◽  
...  
Keyword(s):  
At Risk ◽  
Steady State ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Oral Suspension ◽  
Safety Study ◽  
Phase 3 ◽  
Once Daily ◽  
Patients At Risk ◽  
Phase 1B

This Phase 1B study showed that a single tablet of 300 mg of posaconazole, given once daily as prophylaxis to 210 patients at risk for invasive fungal disease, was as safe as that reported for posaconazole oral suspension and achieved steady-state >500 ng/mL for all but one patient.

scholarly journals Phase 3 pharmacokinetics and safety study of a posaconazole tablet formulation in patients at risk for invasive fungal disease

2016 ◽  
Vol 71 (6) ◽  
pp. 1747-1747 ◽  
Author(s):  
Oliver A. Cornely ◽  
Rafael F. Duarte ◽  
Shariq Haider ◽  
Pranatharthi Chandrasekar ◽  
David Helfgott ◽  
...  
Keyword(s):  
At Risk ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Tablet Formulation ◽  
Safety Study ◽  
Phase 3 ◽  
Patients At Risk

Psychiatric Treatment Strategies for Patients at Risk of Dying Suddenly

1991 ◽  
Vol 56 (4) ◽  
pp. 242-246
Author(s):  
Brian Baker ◽  
Paul Dorian ◽  
Nadia Woloshyn ◽  
Shahe Kazarian ◽  
Caroline Lanphier
Keyword(s):  
At Risk ◽  
Psychiatric Treatment ◽  
Treatment Strategies ◽  
Patients At Risk

scholarly journals Phase 1B Study of the Pharmacokinetics and Safety of Posaconazole Intravenous Solution in Patients at Risk for Invasive Fungal Disease

2014 ◽  
Vol 58 (7) ◽  
pp. 3610-3617 ◽  
Author(s):  
Johan Maertens ◽  
Oliver A. Cornely ◽  
Andrew J. Ullmann ◽  
Werner J. Heinz ◽  
Gopal Krishna ◽  
...  
Keyword(s):  
Steady State ◽  
Invasive Fungal Disease ◽  
Central Line ◽  
Fungal Disease ◽  
Average Concentration ◽  
Study Phase ◽  
Time Curve ◽  
Exposure Target ◽  
Patients At Risk ◽  
Phase 1B

ABSTRACTThis was a phase 1B, dose-ranging, multicenter, pharmacokinetics, and safety study of cyclodextrin-based posaconazole intravenous (i.v.) solution administered through a central line to subjects at high risk for invasive fungal disease (part 1 of a 2-part study [phase 1B/3]). Initially, the safety and tolerability of single-dose posaconazole i.v. 200 mg (n= 10) were compared with those of a placebo (n= 11). Subsequently, 2 doses were evaluated, posaconazole i.v. 200 mg once daily (q.d.) (n= 21) and 300 mg q.d. (n= 24). The subjects received twice-daily (b.i.d.) posaconazole i.v. on day 1, followed by 13 days of posaconazole i.v. q.d., then 14 days of posaconazole oral suspension 400 mg b.i.d. The steady-state (day 14) exposure target (average concentration [areas under concentration-time curve {AUCs}/24 h, average concentrations at steady state {Cavgs}], of ≥500 to ≤2,500 ng/ml in ≥90% of the subjects) was achieved by 94% of the subjects for 200 mg posaconazole q.d. and by 95% of subjects for 300 mg posaconazole q.d. The desired exposure target (mean steady-stateCavg, ∼1,200 ng/ml) was 1,180 ng/ml in the 200-mg dosing cohort and was exceeded in the 300-mg dosing cohort (1,430 ng/ml). Posaconazole i.v. was well tolerated. Posaconazole i.v. 300 mg q.d. was selected for the phase 3 study segment. (This study has been registered at ClinicalTrials.gov under registration no. NCT01075984.)

P249 ANALYSIS OF THE SENSITIVITY OF THE UK GUIDELINES ON IDENTIFICATION OF PATIENTS AT RISK OF DEVELOPING REFEEDING SYNDROME

2009 ◽  
Vol 4 (2) ◽  
pp. 130
Author(s):  
S.S. Zeki ◽  
A. Culkin ◽  
J.M.D. Nightingale ◽  
T. Shepherd ◽  
S.M. Gabe
Keyword(s):  
At Risk ◽  
Refeeding Syndrome ◽  
Patients At Risk ◽  
The Uk
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