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|Title:||Treatment of scedosporiosis with Voriconazole: Clinical experience with 107 patients|
|Citation:||Antimicrobial Agents and Chemotherapy, 2008; 52(5):1743-1750|
|Publisher:||Amer Soc Microbiology|
|Peter Troke, Koldo Aguirrebengoa, Carmen Arteaga, David Ellis, Christopher H. Heath, Irja Lutsar, Montserrat Rovira, Quoc Nguyen, Monica Slavin, and Sharon C. A. Chen|
|Abstract:||The efficacy of voriconazole in 107 patients with scedosporiosis was analyzed. Principal infection sites were the lungs/sinuses (24%), central nervous system (CNS) (20%), and bone (18%), while 21% of patients had disseminated infection. Solid organ transplantation (22%), hematological malignancy (21%), and surgery/trauma (15%) were the predominant underlying conditions. A successful therapeutic response was achieved in 57% of patients (median, 103 therapy days), with > 98% of those responding receiving > or = 28 days of therapy. Patients receiving primary therapy showed a 61% response versus 56% for the others. The best therapeutic responses were seen for skin/subcutaneous (91%) or bone (79%) infections, and the lowest for CNS infections (43%). Patients without major immune suppression (72%) or those with solid organ transplantation (63%) or various hematological conditions (60%) showed the best responses by underlying condition. Median known survival time was 133 days (therapy successes, 252 days; failures, 21 days). In all, 43 (40%) patients died, 73% due to scedosporiosis. Patients with Scedosporium prolificans infection had significantly reduced survival times (P = 0.0259) and were more likely to die from fungal infection (P = 0.002) than were Scedosporium apiospermum-infected patients. In a subset of 43 patients where voriconazole baseline MICs were available, response to voriconazole was higher for S. apiospermum-infected patients (54% response; MIC(50), 0.25 microg/ml) than for S. prolificans-infected patients (40% response; MIC(50), 4.0 microg/ml). Voriconazole demonstrated clinically useful activity in the treatment of both S. apiospermum and S. prolificans infections and was well tolerated.|
|Keywords:||Global Scedosporium Study Group; Humans; Scedosporium; Aspergillosis; Triazoles; Pyrimidines; Antifungal Agents; Treatment Outcome; Health Surveys; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Child; Child, Preschool; Infant; Female; Male; Clinical Trials as Topic|
|Appears in Collections:||Molecular and Biomedical Science publications|
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