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足菌肿的管理:治疗挑战与药物警戒的作用

Mycetoma managment: Therapeutic challenges and the role of pharmacovigilance.

作者信息

Hussein Samira M E, Saeed Ali Awadallah, Fahal Ahmed Hassan

机构信息

Mycetoma Research Center, Soba University Hospital, University of Khartoum, Khartoum, Sudan.

出版信息

PLoS Negl Trop Dis. 2025 Feb 20;19(2):e0012827. doi: 10.1371/journal.pntd.0012827. eCollection 2025 Feb.

Abstract

Mycetoma presents numerous therapeutic challenges, particularly due to delays in diagnosis, the toxic nature of existing antifungals and antibiotics treatments, and the lack of robust clinical evidence to guide care. This neglected tropical disease, which primarily affects low-resource regions, is further complicated by socio-economic barriers that limit access to healthcare and treatment. These challenges underscore the urgent need for better treatment options, more comprehensive research, and strengthened pharmacovigilance systems to monitor treatment safety and efficacy. Pharmacovigilance plays a critical role in managing mycetoma due to the prolonged and often toxic treatment regimens required. Adverse drug reactions, drug interactions, and treatment side effects need continuous monitoring to ensure patient safety. Effective pharmacovigilance systems should be adapted to the resource-limited settings where mycetoma is most prevalent, integrating into broader public health efforts to improve both the safety and efficacy of treatments. Such systems could greatly enhance patient outcomes by preventing unnecessary harm from toxic therapies and ensuring proper drug use. However, several barriers remain in endemic regions, including inadequate healthcare infrastructure, a lack of trained healthcare professionals, and limited access to pharmacovigilance tools. Addressing these issues requires building stronger national systems, offering more training for healthcare workers, and leveraging innovative technologies such as mobile health tools. Additionally, involving patients in reporting adverse effects could enhance the accuracy and reliability of pharmacovigilance data. Global collaboration and increased clinical research are also essential in improving mycetoma treatment. Investment in these areas, alongside the development of infrastructure and education in endemic countries, will help ensure safer long-term medical therapies and better outcomes for mycetoma patients. Furthermore, improving pharmacovigilance practices is critical to ensuring that vulnerable populations receive the most effective and safe care possible for this neglected disease.

摘要

足菌肿带来了诸多治疗挑战,尤其是由于诊断延误、现有抗真菌和抗生素治疗的毒性本质,以及缺乏有力的临床证据来指导治疗。这种被忽视的热带病主要影响资源匮乏地区,社会经济障碍进一步加剧了其复杂性,这些障碍限制了获得医疗保健和治疗的机会。这些挑战凸显了迫切需要更好的治疗选择、更全面的研究以及加强药物警戒系统以监测治疗的安全性和有效性。由于所需的治疗方案漫长且往往具有毒性,药物警戒在足菌肿的管理中起着关键作用。药物不良反应、药物相互作用和治疗副作用需要持续监测以确保患者安全。有效的药物警戒系统应适应足菌肿最流行的资源有限环境,融入更广泛的公共卫生努力中,以提高治疗的安全性和有效性。这样的系统可以通过防止有毒疗法造成不必要的伤害并确保药物的正确使用,极大地改善患者的治疗结果。然而,在流行地区仍存在一些障碍,包括医疗基础设施不足、缺乏训练有素的医疗专业人员以及获得药物警戒工具的机会有限。解决这些问题需要建立更强大的国家系统,为医护人员提供更多培训,并利用移动健康工具等创新技术。此外,让患者参与不良反应报告可以提高药物警戒数据的准确性和可靠性。全球合作和增加临床研究对于改善足菌肿治疗也至关重要。在这些领域进行投资,以及在流行国家发展基础设施和开展教育,将有助于确保为足菌肿患者提供更安全的长期医疗治疗和更好的治疗结果。此外,改善药物警戒实践对于确保弱势群体获得针对这种被忽视疾病的最有效和安全的护理至关重要。

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