fluconazole oral / Generic mfg. - LARVOL DELTA

The effect of belumosudil on the therapeutic monitoring of tacrolimus and sirolimus in allogeneic hematopoietic transplantation (ASH 2025) - "Azoles were used concomitantly in 51.5% of patients (35/68), with 65.7% (23/35) on posaconazole, 31.4% (11/35) on isavuconazole, and 2.9% (1/35) on voriconazole. Four patients started an azole after starting belumosudil (2 on posaconazole, 1 on fluconazole, and 1 on isavuconazole)... Our study confirms the drug interaction between TAC/SIRO, with the increase in TAC/SIRO levels more pronounced with the second level after starting belumosudil. However, severe toxicities were rarely seen. Based on our data, we recommend close TDM of TAC and SIRO, but no dose adjustment is warranted when belumosudil is added."

Acute Kidney Injury • Chronic Graft versus Host Disease • Graft versus Host Disease • Immunology • Movement Disorders • Nephrology • Transplantation • CYP3A4

Dose modifications of mezigdomide when coadministered with CYP3A4 inhibitors for patients with relapsed/refractory multiple myeloma (ASH 2025) - P1/2 | "Introduction: Mezigdomide (MEZI), an oral CELMoD™ agent with potent antimyeloma and immunostimulatory effects, has demonstrated encouraging efficacy in relapsed/refractory multiple myeloma (RRMM) as monotherapy and in combination with dexamethasone/standard treatments (CC-92480-MM-001 [NCT03374085]; CC-92480-MM-002 [NCT03989414])...A phase 1 clinical drug–drug interaction (DDI) study in healthy participants evaluated MEZI as a substrate of cytochrome P450 3A4 (CYP3A4), using rifampin (strong inducer) and itraconazole (strong inhibitor)...Specifically, MEZI CL was reduced 0.15-, 0.11- and 0.38-fold when administered with posaconazole, voriconazole, and fluconazole, respectively... MEZI is a sensitive CYP3A4 substrate. Modeling and simulation provide a robust framework to guide dose adjustments and manage potential DDI risks while preserving efficacy. For pts requiring concomitant use of strong or moderate CYP3A4is, MEZI can be continued safely with dose..."

Clinical • Hematological Disorders • Hematological Malignancies • Multiple Myeloma • Neutropenia • Thrombocytopenia

CYP3A4 inhibitors (CYP3A4i) and myelosuppression in patients (Pts) with newly diagnosed mutant isocitrate dehydrogenase 1 (mIDH1) Acute Myeloid Leukemia (AML) in the phase 3 AGILE study (ASH 2025) - P3 | "Introduction Ivosidenib (IVO) is an oral, targeted, small-molecule inhibitor of mIDH1 approved for the treatment of ptswith mIDH1 AML. In the pivotal AGILE study of IVO in combination with azacitidine (AZA) in newlydiagnosed AML (NCT03173248), the most common grade ≥3 adverse events (AEs) were hematologic inboth the IVO+AZA and placebo (PBO)+AZA arms (Montesinos, NEJM 2022)...Forexample, venetoclax requires dose reduction when administered concomitantly with CYP3A4i, yetincreased exposure and myelosuppression still occur (Kawedia, AJH 2025)...Population PK modeling predicted theAUC of IVO at SS to increase moderately (<2-fold) when coadministered with voriconazole, fluconazole,and posaconazole—by 48.7%, 60.8%, and 58.8%, respectively—compared with IVO alone...However, low rates of individual AEs limit the ability to draw firm conclusions.IVO exposure was predicted to increase <2-fold when given in combination with moderate/strongCYP3A4i. As concomitant use of..."

Clinical • P3 data • Acute Myelogenous Leukemia • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • Thrombocytopenia • CYP3A4 • IDH1 • TINCR

Tailoring Nanoparticle Surfaces Empowered by Multivariate Techniques for Detection of Multiple Antibiotic Fingerprints in Real Samples Using Hand-Held Colorimetric Signal Readout. (PubMed, ACS Appl Mater Interfaces) - "With 100% accuracy, the sensor array successfully discriminates between eight antibiotics (amoxicillin, azithromycin, neomycin, streptomycin, chloramphenicol, ofloxacin, fluconazole, and ciprofloxacin), with detection limits ranging from 1.7 to 8.3 μM. Further, for the real-time applications, we have developed prototypes for colorimetric analysis and also modified the previously developed 96-well plate reader, which functions similarly to the UV-visible absorption spectrophotometer. These on-site sensing methods, with straightforward preparation, quick response, exceptional sensitivity, and consistently stable high-throughput signal output, show significant potential for practical use in food forensics and for environmental remediation."

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Fungal infections following chimeric antigen receptor T-cell (CAR-T) cell therapy: A retrospective case-control study in the south-central US (ASH 2025) - "Twopatients had bloodstream infections (BSI) breaking through micafungin, one with Cryptococcusneoformans, and one with Candida krusei. Another three patients broke through fluconazole, one withCandida glabrata BSI, one with Candida krusei BSI and one with Aspergillus pneumonia. The last twopatients broke through posaconazole, one with invasive aspergillosis and one with Trichodermapneumonia... While uncommon, invasive fungal infections tend to occur early after CAR-T therapy and are associatedwith markedly increased mortality despite antifungal prophylaxis. Patients with B-ALL, particularly thosewith a prior allogeneic HCT, patients with prolonged neutropenia or CMV reactivation after CAR T, seemto be at the highest risk. Larger prospective studies are needed to identify the subset of CAR-T recipientsto target for individualized antifungal prophylactic strategies."

CAR T-Cell Therapy • Retrospective data • Hematological Malignancies • Infectious Disease • Lymphoma • Multiple Myeloma • Neutropenia • Pneumonia • Respiratory Diseases

Intrinsic resistance to short-tailed azoles in the basal fungus Mucor lusitanicus: functional analysis of Cyp51 isoforms and amino acid substitutions. (PubMed, Front Microbiol) - "The basal fungus Mucor lusitanicus (Mlu) is a cause of mucormycosis, with limited treatment options due to intrinsic resistance to short-tailed azoles (fluconazole, voriconazole) and echinocandins. Susceptibility to long-tailed azoles (e.g., posaconazole) remained unchanged for both isoforms. These findings demonstrate the functional expression of MluCyp51-F1 and MluCyp51-F5 isoforms in a phylogenetically distant host and confirm that conserved substitutions Y129F and V293A in MluCyp51-F5 confer intrinsic resistance to short-tailed azoles in M. lusitanicus."

Journal • Infectious Disease

Cardiotoxicity associated with antifungal agents: A pharmacovigilance analysis of the FDA Adverse Event Reporting System. (PubMed, Int J Clin Pharmacol Ther) - "These findings highlight that azoles and polyenes show substantial associations with CAEs, particularly for TdP/QTP and arrhythmias. Itraconazole showed a significant association with cardiac failure and cardiomyopathy, while the signal for isavuconazole was weaker than for other triazoles. No significant cardiotoxicity signals were detected for echinocandins."

Adverse events • Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Ventricular Tachycardia

Factors Associated with Candidemia After Living Donor Liver Transplantation: A Case-Control Study. (PubMed, J Clin Med) - " Univariate analysis revealed significant associations with prolonged intubation (p < 0.001), bile leaks (p < 0.001), relaparotomy (p < 0.001), chronic renal disease (p = 0.011), hepatocellular carcinoma (p = 0.011), and the use of antimicrobials including meropenem (p = 0.048), linezolid (p = 0.005), tigecycline (p = 0.045), third-generation cephalosporins (p = 0.003), anidulafungin (p < 0.001), fluconazole (p = 0.006), mycophenolate (p = 0.011), and total parenteral nutrition (TPN) (p = 0.049). Prolonged intubation, bile leaks, antifungal exposure, and lack of CMV prophylaxis are independently associated with higher odds of candidemia after LDLT. Targeted prophylaxis, prudent antimicrobial stewardship, and timely biliary intervention may reduce fungal morbidity and mortality in post-transplant patients."

Journal • Chronic Kidney Disease • Hepatocellular Cancer • Infectious Disease • Nephrology • Oncology • Renal Disease • Solid Tumor • Transplantation

Species distribution, antifungal susceptibility, and clinical profiles of patients with osteoarticular fungal Infections: A retrospective study. (PubMed, New Microbes New Infect) - "Fungal identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), followed by broth microdilution antifungal susceptibility testing for amphotericin B (AMB), fluconazole (FLC), voriconazole (VRC), and posaconazole (POS). Antifungal susceptibility testing revealed VRC and POS as potentially effective therapeutic options for OAFIs. These findings underscore the need for early detection of rare fungal pathogens, susceptibility-guided therapy, and continuous resistance surveillance in managing OAFIs in non-immunodeficient patients."

Journal • Retrospective data • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Musculoskeletal Diseases • Rheumatology

Assessment of Clinical Guideline Use in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis Among Health Care Providers in Ethiopia. (PubMed, Open Forum Infect Dis) - "Among antifungals, fluconazole was the most available, with 21/44 (48%) pharmacists and 49/202 (24%) HCWs reporting it as always in stock. Liposomal amphotericin B (L-Amb) was reported as available by only 7/44 (16%) pharmacists and 44/202 (22%) HCWs. The most significant barriers to guideline implementation were insufficient policy support and challenges in integrating guidelines into electronic health records, as reported by 152/202 (75.2%) and 143/202 (70.8%) HCWs, respectively. There are substantial gaps in CM care, highlighting the importance of improving resource allocation, technical assistance, additional training, and financial support."

Clinical guideline • Journal • CNS Disorders • Human Immunodeficiency Virus • Infectious Disease

Evidence Based Approach of Antifungal Prophylaxis (AFP) in Hematological Malignancies (DGHO 2025) - "Ten trials with HMA monotherapy (n=1,185), 10 with HMA/venetoclax (n=956) and 4 with FLT3-inhibitors (n=273) were analyzed...No prospective RT for AFP with isavuconazole, rezafungin or olorofim are available.In pts receiving HMA therapy, IFI ranged between 1.6 and 10.3% while AFP was usually not given...In pts treated with midostaurin, two studies (n= 218 pts) reported 29 IFI (13.3%). A total of 20,753 AFP pts episodes (eps) were included since 1984 from 95 studies during CTx and 17,482 pts received AFP within a clinical trial for AFP from 1992 to 2022. Out of these, 7,586 received fluconazole (FLU), 4,080 were on trials with posaconazole (POS) or voriconazole (VOR), 1,717 received itraconazole (ITRA), 1,895 echinocandins and 1,594 amphotericin B (AmB)(AmB deoxycholate, liposomal AmB or inhalative AmB), respectively. In pts receiving novel targeted therapies (e.g."

Hematological Malignancies • Infectious Disease • Leukemia • Myelodysplastic Syndrome • Neutropenia • Oncology

The Use of Antifungal Prophylaxis Is Associated with Worse Outcomes in Patients with Newly Diagnosed AML Treated with Venetoclax/HMA: A Retrospective Analysis of Patients in the Flatiron Health Database (ASH 2024) - "Among patients who received AFP, 172 (41%) received fluconazole, 128 (30%) received voriconazole, 52 (12%) received isavuconazole, and 68 (16%) received posaconazole. This further limited the ability to assess how venetoclax doses were modified. Finally, there may have been selection bias with some patients receiving antifungal prophylaxis because of additional patient or disease-related characteristics that could have impacted outcomes."

Retrospective data • Acute Myelogenous Leukemia • Hematological Malignancies • Infectious Disease • Leukemia • Oncology • ASXL1 • RUNX1 • TP53

40 Years of Preventing Fungal Infections in Hematological Malignancies - Lessons Learned from Clinical Trials with 20,753 Patients (ASH 2024) - "Out of these, 7,586 received fluconazole (FLU), 4,080 were included in trials with posaconazole (POS) or voriconazole (VOR), 1,717 received itraconazole (ITRA), 1,895 echinocandins and 1,594 amphotericin B (AmB)(AmB deoxycholate, liposomal AmB or inhalational AmB), respectively...No prospective studies for AFP with isavuconazole and new antifungal agents like rezafungin or olorofim are available...In those receiving venetoclax/HMA, AFP practices were heterogeneous and IFI incidence ranged from 5% to 16.1% (overall probable/proven IFI : n=102 (10.6%), possible IFI not reported in all studies). In pts treated with midostaurin, 2 studies (n= 218 pts) reported 29 probable/proven IFI (13.3%). In pts treated with gilteritinib, 2 studies reported 55 pts with an IFI rate of 27.2% (including possible IFI)...Despite numerous trials for prevention of IFI, only posaconazole and fluconazole proved reduction in OM rates. There is a need for prospective clinical trials addressing..."

Clinical • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Myelodysplastic Syndrome • Neutropenia • Oncology

Electrosynthesis of High-Valent Iridium-Oxo Species for Efficient Oxygen Transfer Defluorination. (PubMed, J Am Chem Soc) - "The resultant HVIO species on L-Ir1/TF selectively cleaved C-F bonds via electrophilic addition, achieving 99.4% fluconazole defluorination in 5 h (surpassing H-Ir1/TF by 2.3 times and PbO2 by 6.7 times). This work establishes single-atom oxidation-state engineering as a new paradigm for green HVMO synthesis, enabling the sustainable degradation of recalcitrant fluorinated contaminants."

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Roles of Paralogous CYP51 Genes in Biological Traits and Sensitivity to DMI Fungicides in Fusarium pseudograminearum. (PubMed, J Agric Food Chem) - "Notably, ΔFpCYP51A and ΔFpCYP51AC mutants were more sensitive to ipconazole, mefentrifluconazole, metconazole, prochloraz, triadimefon, and tebuconazole...These results demonstrate that FpCYP51A and FpCYP51B are critical for regulating DMI sensitivity. The results provide important insights into the CYP51 function in plant pathogens and support the improved development of DMI fungicides."

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Effectiveness of Piper longum Extract as Natural Irrigant on Antimicrobial Properties and Smear Layer Removal: A Scanning Electron Microscope Study. (PubMed, J Contemp Dent Pract) - "There is a growing need for biocompatible and sustainable alternatives to synthetic irrigants, which may cause adverse effects such as tissue toxicity or dentin erosion. This study explores the potential of P. longum, a natural herbal extract with known antimicrobial and anti-inflammatory properties, as an adjunctive irrigant in root canal therapy. How to cite this article: Varshasree S, Sinduja P, Manjesh D, et al. Effectiveness of Piper longum Extract as Natural Irrigant on Antimicrobial Properties and Smear Layer Removal: A Scanning Electron Microscope Study. J Contemp Dent Pract 2025;26(11):1073-1078."

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Design, synthesis, antifungal activity, and molecular docking studies of benzothiazole, S-benzyl-2,4-isodithiobiuret, and thiourea derivatives of 1-hepta-O-benzoyl-β-d-maltose nanoparticles. (PubMed, Bioorg Med Chem Lett) - "The surge in fungal infection-related mortality worldwide is being caused by drug resistance to well-established antifungals such azole derivatives (bifonazole, fluconazole, miconazole, and clotrimazole)...Almost all the compounds were found to be highly potent than established antifungal drugs (MIC ¼ 0.25-0.125 mg mL-1) against Candida albicans strain. An in silico molecular docking study was also performed to comprehend the mode of action of the active compounds towards prospective target 1EA1 binding protein."

Journal • Infectious Disease

Synthesis of O-Prenylated O-Glycosylated and O-Benzylated Phenazines Derivatives and Their Antimicrobial and Molecular Docking Studies. (PubMed, Chem Biodivers) - "Specifically, compounds 4e, 6e, and 7e exhibited considerable antibacterial activity, inhibiting zones of up to 12 mm, whereas compounds 4c, 4d, 6e, and 7c possessed moderate antifungal activity (12-13 mm), compared to fluconazole (23 mm). Structure-activity relationship analysis proposes the integration of halog substituents and glycosylation leads to increased potency by increasing lipophilicity and interacting better with membranes. Molecular docking studies also confirmed these findings, revealing suitable binding affinities of the active compounds with microbial target proteins. Overall, this work offers new phenazine scaffolds potential candidates for the development of antibacterial and antifungal drugs."

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Epidemiology, clinical features, antifungal resistance, and prognosis of fungemia in pediatric patients. (PubMed, J Infect Dev Ctries) - "Neonates represented the highest-risk population for pediatric fungemia, with a median hospitalization duration of 37 days. Over half of the affected children (56.4%) required ICU admission. The high rate of antifungal resistance and poor prognosis underscore the urgent need for enhanced surveillance protocols and optimized antifungal stewardship in pediatric settings."

Journal • Retrospective data • Critical care • Hematological Disorders • Infectious Disease • Neutropenia • Pediatrics

Stress-driven emergence of heritable non-genetic drug resistance. (PubMed, Res Sq) - "We find that para-resistance is common in clinical isolates and, remarkably, passage through the mammalian gut triggers its acquisition, compromising fluconazole's therapeutic efficacy. Our work defines a pervasive, prion-like epigenetic mechanism of stress adaptation and highlights potential strategies to mitigate the rapid emergence of drug resistance."

Journal • Infectious Disease

A Challenging Case of Hypercalcemia Caused by a Novel Homozygous Variant Missense Mutation in the CYP24A1 Gene. (PubMed, JCEM Case Rep) - "He also received fluconazole 50 mg daily and magnesium glycinate 850 mg 12 hourly for 3 months...This case underscores the importance of considering CYP24A1 pathogenic variant in unexplained hypercalcemia. Identification of a novel variant expands the genetic landscape of hypercalcemia and supports further exploration of targeted therapies."

Journal • Endocrine Disorders • Metabolic Disorders • Nephrology • Renal Calculi • CYP24A1

Enhanced antimicrobial efficacy of a vancomycin/zinc oxide/chitosan nanocomposite via Bacillus licheniformis-mediated biomodification. (PubMed, Discov Nano) - "Compared to common drugs like fluconazole and vancomycin, VA/ZnO/CS demonstrated significantly higher levels of biocidal activity in the agar well-diffusion test, minimum inhibitory concentration (MIC), and minimum microbicidal concentration (MMC). The powerful antimicrobial action of VA/ZnO/CS was demonstrated by the TEM micrographs of C. albicans showing malformations and distortions of cell structure, including cell wall destruction and the emergence of vacuoles. Based on the results, the green synergy between ZnO/CS nanocomposite and VA will provide an effective biomaterial for treating infections and microbial diseases."

Journal • Infectious Disease • Pneumonia • HNRNPD

Developmental toxicity of fluconazole and 1,2,4-triazole in Xenopus laevis. (PubMed, Sci Rep) - "These findings demonstrate that even the core structural motif TRI can disrupt key developmental signaling pathways in vertebrate embryos, underscoring the need for closer monitoring of azole compounds in aquatic environments. Given the fundamental role of these pathways in vertebrate development, the results raise concerns about potential risks from long-term or prenatal exposure to azoles, in both environmental and clinical contexts."

Journal

γ-mangostin from Garcinia mangostana (L.) exerts the antifungal activity against Cryptococcus neoformans by inhibiting ribosome biogenesis. (PubMed, J Ethnopharmacol) - "γ-mangostin holds potential application value in the treatment of infections caused by C. neoformans."

Journal • Infectious Disease

The molecular basis of intrinsic resistance to azoles in Rhizopus arrhizus. (PubMed, Antimicrob Agents Chemother) - "Mucormycetes are intrinsically resistant to the widely used short-tailed azole drugs fluconazole and voriconazole, but susceptible to the long-tailed, though expensive, azole posaconazole. The heterologous overexpression of individual recombinant R. arrhizus CYP51 isoforms in a S. cerevisiae host, with or without the cognate NADPH-cytochrome P450 reductase (RaCPR), and selective genetic modification of CYP51-F5 have tested this hypothesis. Complementary gene deletion experiments in Rhizopus microsporus confirm that the amino acid residues that align with R. arrhizus CYP51-F5 F129 and A291 determine the resistance or susceptibility pattern of R. arrhizus to short-, medium-, and long-tailed azoles."

Journal • Infectious Disease • Novel Coronavirus Disease