Fungal Infections

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Obesity significantly impacts the pharmacokinetics (PK) of antifungal drugs like echinocandins, including volume of distribution (Vd) and clearance. However, despite these PK differences, current clinical evidence generally does not support the need for universal dose adjustments in obese patients. Clinicians should consider personalized dosing based on patient characteristics, infection severity, and specific drug properties due to echinocandins' favorable safety profiles.

This systematic review focuses on breakthrough invasive fungal infections (bIFIs) in patients with high-risk hematological cancers, like acute leukemia, or those who have undergone stem cell transplants. Despite prophylactic antifungal treatments (usually with voriconazole or posaconazole), bIFIs remain challenging due to their complexity and high mortality rates.