Sections

Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Continuous antifungal therapy is effective in preventing infection by Aspergillus species.^[41]

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Trimethoprim and sulfamethoxazole (Bactrim, Septra)

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Trimethoprim and sulfamethoxazole (TMP-SMZ) is current standard therapy. It inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. The antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa.

Class Summary

These agents exert a fungicidal effect by altering the permeability of the fungal cell membrane. Their mechanism of action may also involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to the fungal cell.

Itraconazole (Sporanox)

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Continuous antifungal therapy is effective in preventing infection by Aspergillus species. Itraconazole is a synthetic triazole antifungal agent that slows fungal cell growth by inhibiting cytochrome P-450–dependent synthesis of ergosterol, a vital component of fungal cell membranes.

Class Summary

These agents regulate the immune system by a variety of mechanisms including enhancing activity of macrophages and cytotoxic actions of T lymphocytes.

Interferon gamma - 1b (Actimmune)

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Interferon (INF)–gamma 1b reduces the frequency and severity of serious infections associated with chronic granulomatous disease (CGD). Interferons are synthesized by eukaryotic cells in response to viruses and a variety of natural and synthetic stimuli. INF-gamma possesses antiviral, immunomodulatory, and antiproliferative activity. INF-gamma has potent phagocyte-activating effects not seen with other interferon preparations, including generation of toxic oxygen metabolites within phagocytes capable of mediating intracellular killing of microorganisms.

Questions

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Scanning electron micrograph of Aspergillus species.

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Author

Roman J Nowicki, MD, PhD Professor and Chairman, Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland

Roman J Nowicki, MD, PhD is a member of the following medical societies: American Academy of Dermatology, European Academy of Allergy and Clinical Immunology, European Academy of Dermatology and Venereology, International Society for Human and Animal Mycology, International Society of Dermatology, Polish Dermatological Society, Polish Society of Allergology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Jacek C Szepietowski, MD, PhD Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Received consulting fee from Orfagen for consulting; Received consulting fee from Maruho for consulting; Received consulting fee from Astellas for consulting; Received consulting fee from Abbott for consulting; Received consulting fee from Leo Pharma for consulting; Received consulting fee from Biogenoma for consulting; Received honoraria from Janssen for speaking and teaching; Received honoraria from Medac for speaking and teaching; Received consulting fee from Dignity Sciences for consulting; .

Chronic Granulomatous Disease Medication

Medication Summary

Antibiotics

Class Summary

Trimethoprim and sulfamethoxazole (Bactrim, Septra)

Trimethoprim and sulfamethoxazole (Bactrim, Septra)

Antifungal agents

Class Summary

Itraconazole (Sporanox)

Itraconazole (Sporanox)

Biologic response modifiers

Class Summary

Interferon gamma - 1b (Actimmune)

Interferon gamma - 1b (Actimmune)

Chronic Granulomatous Disease Medication

Medication Summary

Antibiotics

Class Summary

Trimethoprim and sulfamethoxazole (Bactrim, Septra)

Trimethoprim and sulfamethoxazole (Bactrim, Septra)

Antifungal agents

Class Summary

Itraconazole (Sporanox)

Itraconazole (Sporanox)

Biologic response modifiers

Class Summary

Interferon gamma - 1b (Actimmune)

Interferon gamma - 1b (Actimmune)

References

Tables

Contributor Information and Disclosures

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