Scholars@Duke
Melissa DePaoli Johnson

Melissa DePaoli Johnson

Professor in Medicine
Medicine, Infectious Diseases
johns200@mc.duke.edu
Duke Box 102359, Durham, NC 27710
Room 173 Hanes House, 315 Trent Drive, Durham, NC 27710

Selected Publications

Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients with Invasive Aspergillosis

Journal Article Open Forum Infectious Diseases · December 20, 2024 AbstractBackgroundInvasive aspergillosis (IA) accounts for nearly 9,000 hospitalizations annually in the US. Early initiation of antif ... Full text Cite

Real-World Antifungal Therapy Patterns Across the Continuum of Care in United States Adults with Invasive Aspergillosis.

Journal Article J Fungi (Basel) · December 17, 2024 Changes to antifungal therapy (AFT) in invasive aspergillosis (IA) may occur due to intolerance, side effects, drug interactions, or lack of response. We describe AFT change patterns in IA patients. This was a US claims data study. IA patients were identif ... Full text Link to item Cite

Consensus recommendations for the use of novel antiretrovirals in persons with HIV who are heavily treatment-experienced and/or have multidrug-resistant HIV-1: Endorsed by the American Academy of HIV Medicine, American College of Clinical Pharmacy: An executive summary.

Journal Article Pharmacotherapy · May 2024 Treatment options are currently limited for persons with HIV-1 (PWH) who are heavily treatment-experienced and/or have multidrug-resistant HIV-1. Three agents have been approved by the U.S. Food and Drug Administration (FDA) since 2018, representing a sign ... Full text Link to item Cite

Consensus recommendations for the use of novel antiretrovirals in persons with HIV who are heavily treatment-experienced and/or have multidrug-resistant HIV-1: Endorsed by the American Academy of HIV Medicine, American College of Clinical Pharmacy.

Journal Article Pharmacotherapy · May 2024 Treatment options are currently limited for persons with HIV-1 (PWH) who are heavily treatment-experienced and/or have multidrug-resistant HIV-1. Three agents have been approved by the U.S. Food and Drug Administration (FDA) since 2018, representing a sign ... Full text Link to item Cite

The importance of pharmacist engagement in diagnostic stewardship

Journal Article Antimicrobial Stewardship and Healthcare Epidemiology · April 16, 2024 Diagnostic stewardship is increasingly recognized as a powerful tool to improve patient safety. Given the close relationship between diagnostic testing and antimicrobial misuse, antimicrobial stewardship (AMS) pharmacists should be key members of the diagn ... Full text Cite

Antibiotic Myths for the Infectious Diseases Clinician.

Journal Article Clin Infect Dis · October 13, 2023 Antimicrobials are commonly prescribed and often misunderstood. With more than 50% of hospitalized patients receiving an antimicrobial agent at any point in time, judicious and optimal use of these drugs is paramount to advancing patient care. This narrati ... Full text Link to item Cite

Utility of triazole antifungal therapeutic drug monitoring: Insights from the Society of Infectious Diseases Pharmacists: Endorsed by the Mycoses Study Group Education and Research Consortium.

Journal Article Pharmacotherapy · October 2023 Triazole antifungals (i.e., fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) are commonly used in clinical practice to prevent or treat invasive fungal infections. Most triazole antifungals require therapeutic drug monitoring (TDM) ... Full text Link to item Cite

C5a-licensed phagocytes drive sterilizing immunity during systemic fungal infection.

Journal Article Cell · June 22, 2023 Systemic candidiasis is a common, high-mortality, nosocomial fungal infection. Unexpectedly, it has emerged as a complication of anti-complement C5-targeted monoclonal antibody treatment, indicating a critical niche for C5 in antifungal immunity. We identi ... Full text Link to item Cite

Impact of alcohol-based hand-rub disinfection on bacterial bioburden on stethoscopes in a real-world clinical setting.

Journal Article Infect Control Hosp Epidemiol · June 2023 In this randomized study, use of alcohol-based hand-rub disinfection significantly reduced bacterial bioburden of stethoscopes in routine clinical use. Prior cleaning of stethoscopes on the study day did not affect baseline contamination rates, which sugge ... Full text Link to item Cite

Harvesting the low-hanging fruit? Comparative assessment of intravenous to oral route antimicrobial conversion policy implementation.

Journal Article Infect Control Hosp Epidemiol · June 2023 Policies that promote conversion of antibiotics from intravenous to oral route administration are considered "low hanging fruit" for hospital antimicrobial stewardship programs. We developed a simple metric based on digestive days of therapy divided by tot ... Full text Link to item Cite

Leveraging diagnostic stewardship within antimicrobial stewardship programmes

Journal Article Drugs in Context · January 1, 2023 Novel diagnostic stewardship in infectious disease consists of interventions that modify ordering, processing, and reporting of diagnostic tests to provide the right test for the right patient, prompting the right action. The interventions work upstream an ... Full text Cite

Real-world effectiveness of antifungal prophylaxis with posaconazole as the primary agent in patients with haematological malignancies.

Journal Article Mycoses · November 2022 BACKGROUND AND OBJECTIVES: Patients undergoing induction/reinduction chemotherapy for haematologic malignancies (HM) are at risk for invasive fungal infections (IFIs). In 2015, Duke University Hospital (DUH) implemented a new standardised fungal prophylaxi ... Full text Link to item Cite

Top Myths of Diagnosis and Management of Infectious Diseases in Hospital Medicine.

Journal Article Am J Med · July 2022 Antimicrobial agents are among the most frequently prescribed medications during hospitalization. However, approximately 30% to 50% or more of inpatient antimicrobial use is unnecessary or suboptimal. Herein, we describe 10 common myths of diagnosis and ma ... Full text Link to item Cite

How to Harness the Power of Social Media for Quality Drug Information in Infectious Diseases: Perspectives on Behalf of the Society of Infectious Diseases Pharmacists.

Journal Article Clin Infect Dis · May 15, 2022 Clinicians, researchers, and the public frequently turn to digital channels and social media for up-to-the-minute information on novel therapeutics and vaccines. The value of credible infectious diseases drug information is more apparent in the setting of ... Full text Link to item Cite

Coronavirus Disease 2019-Associated Invasive Fungal Infection.

Journal Article Open Forum Infect Dis · December 2021 Coronavirus disease 2019 (COVID-19) can become complicated by secondary invasive fungal infections (IFIs), stemming primarily from severe lung damage and immunologic deficits associated with the virus or immunomodulatory therapy. Other risk factors include ... Full text Open Access Link to item Cite

Reply to Day et al.

Journal Article J Infect Dis · November 16, 2021 Full text Link to item Cite

Effects of a Collaborative, Community Hospital Network for Antimicrobial Stewardship Program Implementation.

Journal Article Clin Infect Dis · November 2, 2021 BACKGROUND: Individual hospitals may lack expertise, data resources, and educational tools to support antimicrobial stewardship programs (ASP). METHODS: We established a collaborative, consultative network focused on hospital ASP implementation. Services i ... Full text Link to item Cite

The host transcriptional response to Candidemia is dominated by neutrophil activation and heme biosynthesis and supports novel diagnostic approaches.

Journal Article Genome Med · July 5, 2021 BACKGROUND: Candidemia is one of the most common nosocomial bloodstream infections in the United States, causing significant morbidity and mortality in hospitalized patients, but the breadth of the host response to Candida infections in human patients rema ... Full text Open Access Link to item Cite

Antifungals in Clinical Use and the Pipeline.

Journal Article Infect Dis Clin North Am · June 2021 Over the past 15 years, there has been an increase in the development and utilization of newer antifungal agents. The ideal antifungal, however, in regard to spectrum of activity, pharmacokinetic/pharmacodynamic properties, development of resistance, safet ... Full text Link to item Cite

Inflammatory Protein Profiles in Plasma of Candidaemia Patients and the Contribution of Host Genetics to Their Variability.

Journal Article Front Immunol · 2021 Circulatory inflammatory proteins play a significant role in anti-Candida host immune defence. However, little is known about the genetic variation that contributes to the variability of inflammatory responses in response to C. albicans. To systematically ... Full text Link to item Cite

Alcohol Hand Rub Significantly Reduces Overall Bacterial Bioburden on Stethoscopes in a Real-World Clinical Setting

Conference Infection Control & Hospital Epidemiology · October 2020 Background: Stethoscopes are a known vector for microbial transmission; however, common strategies used to clean stethoscopes pose certain barriers that prevent routine cleaning after every use. We aimed to determine whether ... Full text Cite

Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium.

Journal Article J Infect Dis · August 5, 2020 In recent years, the global public health community has increasingly recognized the importance of antimicrobial stewardship (AMS) in the fight to improve outcomes, decrease costs, and curb increases in antimicrobial resistance around the world. However, th ... Full text Link to item Cite

Invasive Fungal Infection After Lung Transplantation: Epidemiology in the Setting of Antifungal Prophylaxis.

Journal Article Clin Infect Dis · January 1, 2020 BACKGROUND: Lung transplant recipients commonly develop invasive fungal infections (IFIs), but the most effective strategies to prevent IFIs following lung transplantation are not known. METHODS: We prospectively collected clinical data on all patients who ... Full text Link to item Cite

Long-term risk of hepatocellular carcinoma mortality in 23220 hospitalized patients treated with micafungin or other parenteral antifungals.

Journal Article J Antimicrob Chemother · January 1, 2020 BACKGROUND: Liver tumours observed in rats exposed to micafungin led to a black box warning upon approval in Europe in 2008. Micafungin's risk for liver carcinogenicity in humans has not been investigated. We sought to describe the risk of fatal hepatocell ... Full text Link to item Cite

Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.

Journal Article Infect Control Hosp Epidemiol · November 2019 We analyzed antibiotic use data from 29 southeastern US hospitals over a 5-year period to determine changes in antibiotic use after the fluoroquinolone US Food and Drug Administration (FDA) advisory update in 2016. Fluoroquinolone use declined both before ... Full text Link to item Cite

A Genome-Wide Functional Genomics Approach Identifies Susceptibility Pathways to Fungal Bloodstream Infection in Humans.

Journal Article J Infect Dis · July 31, 2019 BACKGROUND: Candidemia, one of the most common causes of fungal bloodstream infection, leads to mortality rates up to 40% in affected patients. Understanding genetic mechanisms for differential susceptibility to candidemia may aid in designing host-directe ... Full text Link to item Cite

Echinocandins for Prevention and Treatment of Invasive Fungal Infections

Chapter · February 13, 2019 This new edition of Antifungal Therapy aims at providing concise, practical, need-to-know information for busy physicians dealing with fungal infections, such as infectious disease physicians, transplant surgeons, dermatologists, and ... ... Cite

Real-world implications of QT prolongation in patients receiving voriconazole and amiodarone.

Journal Article J Antimicrob Chemother · January 1, 2019 OBJECTIVES: Voriconazole, a triazole antifungal, is frequently prescribed in a complex patient population with comorbidities that require concomitant administration of QT interval-prolonging medications. We sought to evaluate QT interval prolongation in pa ... Full text Link to item Cite

Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals.

Journal Article Infect Control Hosp Epidemiol · June 2018 OBJECTIVETo determine the feasibility and value of developing a regional antibiogram for community hospitals.DESIGNMulticenter retrospective analysis of antibiograms.SETTING AND PARTICIPANTSA total of 20 community hospitals in central and eastern North Car ... Full text Link to item Cite

The homozygous CX3CR1-M280 mutation impairs human monocyte survival.

Journal Article JCI Insight · February 8, 2018 Several reports have demonstrated that mouse Cx3cr1 signaling promotes monocyte/macrophage survival. In agreement, we previously found that, in a mouse model of systemic candidiasis, genetic deficiency of Cx3cr1 resulted in increased mortality and impaired ... Full text Link to item Cite

An integrative genomics approach identifies novel pathways that influence candidaemia susceptibility.

Journal Article PLoS One · 2017 Candidaemia is a bloodstream infection caused by Candida species that primarily affects specific groups of at-risk patients. Because only small candidaemia patient cohorts are available, classical genome wide association cannot be used to identify Candida ... Full text Link to item Cite

Vav Proteins Are Key Regulators of Card9 Signaling for Innate Antifungal Immunity.

Journal Article Cell Rep · December 6, 2016 Fungal infections are major causes of morbidity and mortality, especially in immunocompromised individuals. The innate immune system senses fungal pathogens through Syk-coupled C-type lectin receptors (CLRs), which signal through the conserved immune adapt ... Full text Link to item Cite

Short-term risk of liver and renal injury in hospitalized patients using micafungin: a multicentre cohort study.

Journal Article J Antimicrob Chemother · October 2016 BACKGROUND: Although echinocandins are generally well tolerated, there is little information on the frequency with which renal and hepatic adverse effects occur during use of micafungin or other parenteral antifungal (PAF) agents in clinical practice. METH ... Full text Link to item Cite

Cardiovascular Disease and HIV: Pathophysiology, Treatment Considerations, and Nursing Implications.

Journal Article Crit Care Nurse · October 2016 HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk facto ... Full text Link to item Cite

Genetic Susceptibility to Fungal Infections: What is in the Genes?

Journal Article Curr Clin Microbiol Rep · June 2016 The development of severe fungal infections has long been associated with traditional risk factors such as profound immunosuppression, yet it remains challenging to understand why under similar conditions only some patients will develop these infections wh ... Full text Link to item Cite

CXCR1-mediated neutrophil degranulation and fungal killing promote Candida clearance and host survival.

Journal Article Sci Transl Med · January 20, 2016 Systemic Candida albicans infection causes high morbidity and mortality and is now the leading cause of nosocomial bloodstream infection in the United States. Neutropenia is a major risk factor for poor outcome in infected patients; however, the molecular ... Full text Link to item Cite

The RIG-I-like helicase receptor MDA5 (IFIH1) is involved in the host defense against Candida infections.

Journal Article Eur J Clin Microbiol Infect Dis · May 2015 The induction of host defense against Candida species is initiated by recognition of the fungi by pattern recognition receptors and activation of downstream pathways that produce inflammatory mediators essential for infection clearance. In this study, we p ... Full text Link to item Cite

Candida infective endocarditis: an observational cohort study with a focus on therapy.

Journal Article Antimicrob Agents Chemother · April 2015 Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and u ... Full text Link to item Cite

Collaborative drug therapy management and comprehensive medication management-2015.

Journal Article Pharmacotherapy · April 2015 The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throu ... Full text Link to item Cite

Predictors of glycaemic control among HIV-positive veterans with diabetes.

Conference Int J STD AIDS · March 2015 Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age. The purpose of this study was to assess the correlation between markers of HIV-infection and diabet ... Full text Link to item Cite

The discriminative capacity of soluble Toll-like receptor (sTLR)2 and sTLR4 in inflammatory diseases.

Journal Article BMC Immunol · November 19, 2014 BACKGROUND: The extracellular domains of cytokine receptors are released during inflammation, but little is known about the shedding of Toll-like receptors (TLR) and whether they can be used as diagnostic biomarkers. METHODS: The release of sTLR2 and sTLR4 ... Full text Link to item Cite

Immunochip SNP array identifies novel genetic variants conferring susceptibility to candidaemia.

Journal Article Nat Commun · September 8, 2014 Candidaemia is the fourth most common cause of bloodstream infection, with a high mortality rate of up to 40%. Identification of host genetic factors that confer susceptibility to candidaemia may aid in designing adjunctive immunotherapeutic strategies. He ... Full text Link to item Cite

Antifungal catheter lock therapy for the management of a persistent Candida albicans bloodstream infection in an adult receiving hemodialysis.

Journal Article Pharmacotherapy · July 2014 Antifungal catheter lock therapy (AfLT) with liposomal amphotericin B has been used in the treatment of pediatric central line infections caused by Candida species; however, reports describing the use of liposomal amphotericin B lock therapy in the adult h ... Full text Link to item Cite

Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

Journal Article Cancer Med · June 2014 In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole ... Full text Open Access Link to item Cite

Role of autophagy genetic variants for the risk of Candida infections.

Journal Article Med Mycol · May 2014 Candida albicans can cause candidemia in neutropenic and critically ill patients and oropharyngeal candidiasis in human immunodeficiency virus (HIV)-positive patients with low CD4(+) counts. Because all patients at risk do not develop Candida infections, i ... Full text Link to item Cite

Autophagy is redundant for the host defense against systemic Candida albicans infections.

Journal Article Eur J Clin Microbiol Infect Dis · May 2014 Autophagy has been demonstrated to play an important role in the immunity against intracellular pathogens, but very little is known about its role in the host defense against fungal pathogens such as Candida albicans. Therefore, the role of autophagy for t ... Full text Link to item Cite

The prevalence of HIV testing in pregnant women.

Conference PHARMACOTHERAPY · 2014 Cite

Circulating galectin-3 in infections and non-infectious inflammatory diseases.

Journal Article Eur J Clin Microbiol Infect Dis · December 2013 Recent studies point to a dual role for galectin-3 as both a circulating damage-associated molecular pattern and a cell membrane-associated pattern recognition receptor. The aim of this study was to assess the potential of circulating galectin-3 for discri ... Full text Link to item Cite

CX3CR1-dependent renal macrophage survival promotes Candida control and host survival.

Journal Article J Clin Invest · December 2013 Systemic Candida albicans infection causes high morbidity and mortality and is associated with neutropenia; however, the roles of other innate immune cells in pathogenesis are poorly defined. Here, using a mouse model of systemic candidiasis, we found that ... Full text Link to item Cite

Increasing echinocandin resistance in Candida glabrata: clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations.

Journal Article Clin Infect Dis · June 2013 BACKGROUND: Fluconazole (FLC) resistance is common in C. glabrata and echinocandins are often used as first-line therapy. Resistance to echinocandin therapy has been associated with FKS1 and FKS2 gene alterations. METHODS: We reviewed records of all patien ... Full text Link to item Cite

Pharmacological considerations in human immunodeficiency virus-infected adults in the intensive care unit.

Journal Article Crit Care Nurse · April 2013 According to estimates, 1.2 million Americans are infected with human immuno deficiency virus (HIV). Because of antiretroviral therapy, persons who have HIV infection or have progressed to AIDS are living longer. As a result, the likelihood that they will ... Full text Link to item Cite

Functional genomics identifies type I interferon pathway as central for host defense against Candida albicans.

Journal Article Nat Commun · 2013 Candida albicans is the most common human fungal pathogen causing mucosal and systemic infections. However, human antifungal immunity remains poorly defined. Here by integrating transcriptional analysis and functional genomics, we identified Candida-specif ... Full text Link to item Cite

Human genetic susceptibility to Candida infections.

Journal Article Med Mycol · November 2012 Infections with Candida spp. have different manifestations in humans, ranging from mucosal to bloodstream and deep-seated disseminated infections. Immunocompromised patients have increased susceptibility to these types of infections, due to reduced capacit ... Full text Link to item Cite

Cost of invasive fungal infections in the era of new diagnostics and expanded treatment options.

Journal Article Pharmacotherapy · October 2012 STUDY OBJECTIVE: To determine the true institutional cost of treating invasive fungal infections in light of recent advances in diagnostic techniques and antifungal therapies for both treatment and prophylaxis of these infections. DESIGN: Economic analysis ... Full text Link to item Cite

Cost of Invasive Fungal Infections in the Era of New Diagnostics and Expanded Treatment Options.

Journal Article Pharmacotherapy · September 18, 2012 STUDY OBJECTIVE: To determine the true institutional cost of treating invasive fungal infections in light of recent advances in diagnostic techniques and antifungal therapies for both treatment and prophylaxis of these infections. DESIGN: Economic analysis ... Full text Link to item Cite

Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood.

Journal Article Eur J Clin Microbiol Infect Dis · September 2012 Species of Candida frequently cause life-threatening infections in neonates, transplant and intensive care unit (ICU) patients, and others with compromised host defenses. The successful management of systemic candidiasis depends upon early, rapid diagnosis ... Full text Open Access Link to item Cite

Toll-like receptor 1 polymorphisms increase susceptibility to candidemia.

Journal Article J Infect Dis · March 15, 2012 BACKGROUND: Candidemia is a severe invasive fungal infection with high mortality. Recognition of Candida species is mediated through pattern recognition receptors such as Toll-like receptors (TLRs). This study assessed whether genetic variation in TLR sign ... Full text Link to item Cite

The impact of caspase-12 on susceptibility to candidemia.

Journal Article Eur J Clin Microbiol Infect Dis · March 2012 Candida is one of the leading causes of sepsis, and an effective host immune response to Candida critically depends on the cytokines IL-1β and IL-18, which need caspase-1 cleavage to become bioactive. Caspase-12 has been suggested to inhibit caspase-1 acti ... Full text Open Access Link to item Cite

Cytokine gene polymorphisms and the outcome of invasive candidiasis: a prospective cohort study.

Journal Article Clin Infect Dis · February 15, 2012 BACKGROUND:  Candida bloodstream infections cause significant morbidity and mortality among hospitalized patients. Although clinical and microbiological factors affecting prognosis have been identified, the impact of genetic variation in the innate immune ... Full text Open Access Link to item Cite

Ertapenem for treatment of osteomyelitis: a case series.

Journal Article BMC Res Notes · November 2, 2011 BACKGROUND: Ertapenem is a once-daily broad spectrum carbapenem that is increasingly used to treat polymicrobial osteomyelitis due to diabetic foot and traumatic wound infections. However, limited data exists on ertapenem use for osteomyelitis. This study ... Full text Link to item Cite

Genetic variation in the dectin-1/CARD9 recognition pathway and susceptibility to candidemia.

Journal Article J Infect Dis · October 1, 2011 BACKGROUND: Candidemia is an important cause of morbidity and mortality in critically ill patients or patients undergoing invasive treatments. Dectin-1 is the main β-glucan receptor, and patients with a complete deficiency of either dectin-1 or its adaptor ... Full text Link to item Cite

Combination antifungal therapy

Journal Article · January 1, 2011 Invasive fungal infections continue to cause significant morbidity and mortality among hospitalized patients. In particular, recent studies indicate an increase in the incidence of mould infections among transplant recipients, and Candida species have rise ... Full text Cite

Host Genomics and Bacterial Infections

Journal Article · December 1, 2010 This chapter focuses on host genomics, highlighting examples of studies aimed at unraveling the complex nature of immune response to infection. Bacterial pathogens are known to cause infectious diseases in humans. Many of these pathogens are commensal orga ... Full text Cite

Use of Antifungal Combination Therapy: Agents, Order, and Timing.

Journal Article Curr Fungal Infect Rep · May 1, 2010 Given the substantial morbidity and mortality related to invasive fungal infections, treatment with a combination of antifungal agents is often considered. A growing body of literature from in vitro studies, animal models, and clinical experience provides ... Full text Link to item Cite

Incidence of Severe Hepatotoxicity Related to Antiretroviral Therapy in HIV/HCV Coinfected Patients.

Journal Article AIDS Res Treat · 2010 Introduction. Hepatotoxicity is a concern in HIV/hepatitis C virus (HCV) coinfected patients due to their underlying liver disease. This study assessed the incidence of hepatotoxicity in HIV/HCV co-infected patients in two outpatient infectious diseases cl ... Full text Link to item Cite

Host Genomics and Bacterial Infections

Journal Article · December 1, 2009 Full text Cite

Human dectin-1 deficiency and mucocutaneous fungal infections.

Journal Article N Engl J Med · October 29, 2009 Mucocutaneous fungal infections are typically found in patients who have no known immune defects. We describe a family in which four women who were affected by either recurrent vulvovaginal candidiasis or onychomycosis had the early-stop-codon mutation Tyr ... Full text Link to item Cite

Pharmacogenomics of systemic antifungal agents

Journal Article Current Fungal Infection Reports · June 1, 2009 The genomic era offers a multitude of new technologies that may make the promise of personalized medicine a reality for patients in this century. Numerous new antifungal agents have been developed over the past two decades, but use of these agents requires ... Full text Cite

Mortality and time to extubation in severe hospital-acquired pneumonia.

Journal Article Am J Infect Control · March 2009 BACKGROUND: This study examined predictors of in-hospital mortality and time to extubation among patients with acute, severe hospital-acquired pneumonia (HAP) managed in the intensive care unit (ICU). METHODS: Patients with HAP prospectively identified bet ... Full text Link to item Cite

Toll like receptor 1 polymorphisms and susceptibility to invasive candidiasis.

Journal Article Critical care (London, England) · January 2009 Full text Cite

Current options in antifungal pharmacotherapy.

Journal Article Pharmacotherapy · May 2008 Infections caused by yeasts and molds continue to be associated with high rates of morbidity and mortality in both immunocompromised and immunocompetent patients. Many antifungal drugs have been developed over the past 15 years to aid in the management of ... Full text Link to item Cite

Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms.

Journal Article Scand J Infect Dis · 2008 Unit-specific antibiograms serve as useful guides to clinicians and infection control personnel. We compared trends in antimicrobial resistance in intensive care units using traditional 2-y unit-specific antibiogram data and 3 y of data. Three-y unit-speci ... Full text Link to item Cite

Safety in healthcare is not a new concept

Journal Article International Surgery · 2008 Cite

A comparison of the effectiveness of lipid-lowering therapy between HIV- and non-HIV-infected subjects with hyperlipidaemia.

Journal Article Int J STD AIDS · December 2007 This retrospective cohort study conducted at the Durham Veterans Affairs Medical Center evaluated the effectiveness and safety of lipid-lowering therapy (LLT) in a HIV-infected population as compared with a general population with hyperlipidaemia. Fifty-th ... Full text Link to item Cite

Fungal infections of the bones and joints.

Journal Article Curr Infect Dis Rep · October 2007 Featured Publication Osteoarticular complications may occur with a variety of invasive fungal infections, and seem to be increasing with growing use of prosthetic joints and as the immunosuppressed patient population increases. Epidemiology, pathogenesis, presentation, and man ... Full text Link to item Cite

Combination antifungal therapy: what can and should we expect?

Journal Article Bone Marrow Transplant · August 2007 Invasive fungal infections are associated with significant morbidity and mortality among immunocompromised patients. Recent advances in antifungal development have afforded us more pharmacologic compounds to choose from when managing these fungal infection ... Full text Link to item Cite

Quantification of 1,3-beta-D-glucan levels in children: preliminary data for diagnostic use of the beta-glucan assay in a pediatric setting.

Journal Article Clin Vaccine Immunol · July 2007 1,3-Beta-D-Glucan serum levels have demonstrated good diagnostic sensitivity and specificity for the diagnosis of candidiasis in adult patients, but normal levels for children have not been established. We found higher 1,3-beta-D-glucan levels in children ... Full text Link to item Cite

Caspofungin for invasive candidiasis at a tertiary care medical center.

Journal Article Am J Med · November 2006 BACKGROUND: Caspofungin is emerging as first-line therapy for invasive candidiasis. Data on the use of caspofungin for treatment for invasive candidiasis are limited to clinical trials and case reports. We report a single-center experience with 104 consecu ... Full text Link to item Cite

Pharmacotherapy for human immunodeficiency virus-associated nephropathy.

Journal Article Pharmacotherapy · December 2005 Approximately 10% of adult patients with human immunodeficiency virus (HIV) infection have HIV-associated nephropathy (HIVAN). This condition, a leading cause of renal failure, is characterized by damage to specific areas of the renal filtration system. It ... Full text Link to item Cite

Pharmacoeconomics of antifungal pharmacotherapy--challenges and future directions.

Journal Article Expert Opin Pharmacother · December 2005 The frequency and severity of invasive fungal infections have been increasingly recognised and new antifungal therapies have expanded the therapeutic armamentarium available to manage such infections. Antifungal agents comprise a significant portion of ant ... Full text Link to item Cite

Combination antifungal therapy.

Journal Article Antimicrob Agents Chemother · March 2004 Featured Publication Full text Link to item Cite

Rational use of antifungals for invasive fungal infections in the institutional setting

Chapter · January 1, 2004 The incidence of invasive fungal infections (IFIs) is increasing at an alarming rate. In the past decade alone, Candida spp. have become the fourth leading cause of nosocomial bloodstream infections in the United States (1). The incidence of Aspergillus in ... Cite

Book Review: Management of the HIV-Infected Patient. 2nd Edition

Journal Article Annals of Pharmacotherapy · June 2003 Full text Cite

Caspofungin: first approved agent in a new class of antifungals.

Journal Article Expert Opin Pharmacother · May 2003 Featured Publication Caspofungin (Cancidas, Merck & Co. Inc.) is the first echinocandin antifungal agent to gain FDA-approval for use in the US. It has excellent clinical activity against Candida spp. and Aspergillus spp. but lacks significant activity against Cryptococcus neo ... Full text Link to item Cite

A randomized comparative study to determine the effect of omeprazole on the peak serum concentration of itraconazole oral solution.

Journal Article J Antimicrob Chemother · February 2003 Featured Publication To determine the effect of omeprazole on peak serum concentrations (C(max)) of itraconazole oral solution (IOS), we carried out a randomized, open-label, prospective, crossover study. Fifteen healthy, non-pregnant adults received a single dose of IOS 400 m ... Full text Link to item Cite

Caspofungin: first approved agent in a new class of antifungals

Journal Article Expert Opinion on Pharmacotherapy · 2003 Full text Cite

Steady-state pharmacokinetics of lamivudine in human immunodeficiency virus-infected patients with end-stage renal disease receiving chronic dialysis.

Journal Article Antimicrob Agents Chemother · August 2002 Featured Publication The steady-state pharmacokinetics of lamivudine were evaluated in 11 subjects with human immunodeficiency virus infection and end-stage renal disease, 9 of whom were receiving hemodialysis and 2 of whom were receiving chronic ambulatory peritoneal dialysis ... Full text Link to item Cite

Chest discomfort associated with liposomal amphotericin B: report of three cases and review of the literature.

Journal Article Pharmacotherapy · 1998 Featured Publication Liposomal formulations of amphotericin B are designed to maintain therapeutic efficacy of amphotericin B deoxycholate while reducing its associated toxicities. In three patients chest discomfort occurred during planned 1-hour infusions of liposomal amphote ... Link to item Cite