Invasive fungal diseases carry high morbidity and mortality in patients undergoing chemotherapy for hematological malignancies or allogeneic hematopoietic stem cell transplantation. In order to prevent these life-threatening infections, antifungal chemoprophylaxis plays an important role in daily clinical practice. Broad-spectrum antifungal triazoles are widely used but exhibit disadvantages such as relevant drug-drug interactions. Therefore, amphotericin B products or echinocandins can be an alternative in selected patient populations. As these compounds are available as intravenous formulations only, there is growing interest in extended dosing regimens. Although not approved for these agents, this strategy is a rational option, as these compounds have properties suitable for this strategy, including dose-proportional pharmacokinetics, prolonged elimination half-life, and a large therapeutic window. As the use of extended dosing regimens in antifungal prophylaxis is expanding in clinical practice, we reviewed the pharmacokinetic and pharmacodynamic rationale for this strategy, animal model data, dose escalation studies, and clinical trials supporting this concept.

中文翻译：

---

真菌预防的延长给药方案。


侵袭性真菌病在接受血液恶性肿瘤化疗或异基因造血干细胞移植的患者中具有较高的发病率和死亡率。为了预防这些危及生命的感染，抗真菌药物预防在日常临床实践中发挥着重要作用。广谱抗真菌三唑类药物被广泛使用，但存在诸如相关药物间相互作用等缺点。因此，两性霉素 B 产品或棘白菌素可以作为特定患者群体的替代品。由于这些化合物仅以静脉注射制剂的形式提供，因此人们对延长给药方案越来越感兴趣。尽管尚未批准用于这些药物，但该策略是一个合理的选择，因为这些化合物具有适合该策略的特性，包括剂量成比例的药代动力学、延长的消除半衰期和较大的治疗窗。随着延长给药方案在抗真菌预防中的使用在临床实践中不断扩大，我们回顾了该策略的药代动力学和药效学原理、动物模型数据、剂量递增研究和支持这一概念的临床试验。