The incidence of fungal infections have increased considerably in the past few years. According to an article published in August 2010 edition of "U.S. Pharmacist," Candida species are the fourth most common cause of hospital-acquired infections in the U.S. Other fungi such as aspergillus, zygomycetes and fusarium are commonly associated with invasive infections, especially in immunocompromised individuals. Antifungals drugs are used to treat a variety of fungal infections. While beneficial, they can sometimes produce side effects.
Gastric Disturbances
Digestive system problems such as nausea, vomiting, diarrhea and lack of appetite are some of the common side effects associated with antifungals. Drugs such as amphoterecin B and fluconazole can cause severe reactions when they are administered intravenously. According to an article published in the December 2005 edition of "The Clinical Risk Management," 4.9 percent of the patients taking oral terbinafine and 3 percent patients taking itraconazole orally suffer from gastric disturbances. The use of fever-reducing medications such as acetaminophen can reduce these side effects of antifungals, especially those caused by amphoterecin B.
Nephrotoxicity
Nephrotoxicity or kidney damage is a relatively serious side effect of amphoterecin B therapy and the extent of damage depends on the dosage and the duration of the treatment. Although most mild cases of renal abnormalities resolve without intervention, some patients may suffer from permanent damage due to extended therapy. According to the Merck Manuals Online Medical Library, about 75 percent of all patients have persistent renal insufficiency. Hence, it is important to monitor the blood creatinine and blood urea nitrogen levels of the patient during the treatment as they are the major indicators of kidney function.
Bone Marrow Suppression
Many antifungal drugs including flucytosine, amphoterecin B, itraconazole and ketoconazole may cause the suppression of the bone marrow, which is the part of the body that is responsible for the production of the blood cells. In fact, according to the information published by the University of Minnesota, when given together, amphoterecin B decreases the excretion of flucytosine and increases its bone marrow suppression abilities. This condition is generally manifested as anemia, which is the lack of the red blood cells, and as leukocytopenia, the deficiency of the white blood cells. As a result, the patient may feel tired and be susceptible to other infections.
Hepatotoxicity
Hepatotoxicity or liver damage is another untoward effect of antifungals drugs. A February 2005 article in "Current Opinion in Investigational Drugs" states that hepatotoxic reactions due to antifungals may range from mild, asymptomatic abnormalities of the liver to potentially life-threatening failure of the liver function. As with nephrotoxicity, most hepatotoxic reactions also resolve at the end of the therapy, but some antifungal agents may induce chronic liver damage.
References
- U.S. Pharmacist: The Fungus Among Us: An Antifungal Review
- Merck Manuals Online Medical Library: Antifungal Drugss
- "The Clinical Risk Management"; Safety and Tolerability of Oral Antifungal Agents in the Treatment of Fungal Nail Disease: A Proven Reality.; Boni Elewski and Amir Tavakkol; December 2005
- University of Minnesota: Antifungal Agents
- "Clinical Opinion in Investigational Drugs"; Hepatotoxicity of Antifungal Agents.; Song JC and Deresinski S.; February 2005
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