Analysis of the range of antifungal drugs for systemic use and evidence-based clinical efficacy and safety of fluconazole
DOI:
https://doi.org/10.24959/cphj.20.1524Keywords:
fungal infections, antifungal drugs, assortment of medicines, pharmaceutical market, clinical efficacy and safety of fluconazoleAbstract
Today, according to the WHO, every fifth inhabitant of the Earth is infected with fungi, and every tenth has pronounced clinical manifestations of fungal diseases. The incidence of mycotic foot infections among the population both in Ukraine and in various European countries varies from 20 to 70 %.
Aim. To analyze the assortment of antifungal drugs for systemic use at the pharmaceutical market of Ukraine within 2016-2018 and the evidence base for efficacy and safety of the antifungal drug – fluconazole.
Materials and methods. The analysis of the assortment of antifungal drugs was performed within 2016-2018 according to the “Pharmstandard” information and search system “Morion” of company. The analysis of clinical efficacy and safety of fluconazole was carried out according to the evidence-based medicine databases, such as Cochrane Library, Trip Database, PubMed, Nice.
Results. Antifungal drugs for systemic use were presented at the pharmaceutical market within 2016-2018 in a sufficient assortment (103-111 TN drugs) based on 7 INN. However, most INN drugs were presented by 1-4 TN and had a narrow price range per package. Only fluconazole preparations had a significant amount of TH at the market (79-89 TN drugs) with a wide range of prices per package (from 8.63 to 1407.29 UAH). In 10 systematic reviews analyzed the results of clinical efficacy and safety of fluconazole for the prevention and treatment of fungal infections in children and adults were presented. Fluconazole has the proven pronounced clinical efficacy and is recommended by the American and European Communities of Infectious Diseases as a first-line therapy for candida infections.
Conclusions. The analysis of systematic reviews and meta-analyses prove the safety and efficacy of fluconazole when used in children and adults for the prevention and treatment of fungal infections.References
Korolenko, V. V. (2010). Suchasnyi stan problemy mikoziv ta zastosuvannia serta-konazolu v yikh likuvanni. Ukrainskyi zhurnal dermato-lohii, venerolohii, kosmetolohii, 3(38),109–116.
Kuts, L. V., Hortynska, O. M. (2019). Mikozy: navchalnyi posibnyk. Sumy: Sumskyi derzhavnyi universytet, 83.
Koliadenko, V. H., Korolenko, V. V. (2003). Suchasni pohliady na klasyfikatsiiu mikroorhanizmiv – zbudnykiv shkirnykh ta venerychnykh khvorob. Ukrainskyi zhurnal dermatolohii, venerolohii, kosmetolohii, 3, 7–11.
Koroleva, Zh. V. (2013). Etiologiia, klinika i optimizatciia terapii pri mikoze stop. Ukrainskyi zhurnal dermatolohii, venerolohii, kosmetolohii, 2(49), 171–175.
Systema doslіdzhennia rinku lіkarskikh zasobіv «Pharmexplorer» kompanії «Morіon». (n.d.). Available at: https://www.pharmstandart.com.ua
Podobed, V. M. (2011). Sovremennyi vzgliad na problemu kandidoza i vozmozhno-sti flukonazola. Meditcinskie novosti, 8, 57–59.
Kontoyiannis, D. P., Bodey, G. P., Mantzoros, C. S. (2001). Fluconazole vs. amphotericin B for the management of candidaemia in adults: a meta-analysis: Mycoses, 44(5), 125–135. https://doi.org/10.1046/j.1439-0507.2001.00649.x
Shorr, A. F., Chung, K., Jackson, W. L., Waterman, P. E., & Kollef, M. H. (2005). Fluconazole prophylaxis in critically ill surgical patients: A meta-analysis*. Critical Care Medicine, 33(9), 1928–1935. https://doi.org/10.1097/01.ccm.0000178352.14703.49
Chen, H., Suda, K. J., Turpin, R. S., Pai, M. P., Bearden, D. T., & Garey, K. W. (2007). High- versus low-dose fluconazole therapy for empiric treatment of suspected invasive candidiasis among high-risk patients in the intensive care unit: a cost-effectiveness analysis. Current Medical Research and Opinion, 23(5), 1057–1065. https://doi.org/10.1185/030079907x182130
Lalla, R. V., Latortue, M. C., Hong, C. H., Ariyawardana, A., D’Amato-Palumbo, S., … Brennan, M. T. (2010). A systematic review of oral fungal infections in patients receiving cancer therapy. Supportive Care in Cancer, 18(8), 985–992. https://doi.org/10.1007/s00520-010-0892-z
Smego, R. A., & Ahmad, H. (2011). The Role of Fluconazole in the Treatment of Candida Endocarditis. Medicine, 90(4), 237–249. https://doi.org/10.1097/md.0b013e3182259d38
Chicella, M. F., Woodruff, E. D., Desai, M. M. (2012). A review of Candida prophylaxis in the neonatal intensive care population. Journal of Pediatric Pharmacology and Therapeutics, 16(4), 237–245.
Blyth, C. C., Barzi, F., Hale, K., & Isaacs, D. (2012). Chemoprophylaxis of neonatal fungal infections in very low birthweight infants: efficacy and safety of fluconazole and nystatin. Journal of Paediatrics and Child Health, 48(9), 846–851. https://doi.org/10.1111/j.1440-1754.2012.02543.x
Gøtzsche, P. C., & Johansen, H. K. (2014). Nystatin prophylaxis and treatment in severely immunodepressed patients. Cochrane Database of Systematic Reviews, 4(9). https://doi.org/10.1002/14651858.cd002033.pub2
Rios, J. F. da S., Camargos, P. A. M., Corrêa, L. P., & Romanelli, R. M. de C. (2017). Fluconazole prophylaxis in preterm infants: a systematic review. The Brazilian Journal of Infectious Diseases, 21(3), 333–338. https://doi.org/10.1016/j.bjid.2017.01.008
Qin, F., Wang, Q., Zhang, C., Fang, C., Zhang, L., Chen, H., … Cheng, F. (2018). Efficacy of antifungal drugs in the treatment of vulvovaginal candidiasis: a Bayesian network meta-analysis. Infection and Drug Resistance, 11, 1893–1901. https://doi.org/10.2147/idr.s175588
Downloads
Published
Issue
Section
License
Copyright (c) 2020 National University of Pharmacy
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).