Breaking the mold: A case of pulmonary mucormycosis treated with isavuconazole

Huggins, Jonathan; Jurdi, Ayman Al; Gupta, Renuka

doi:10.1016/j.mmcr.2018.11.004

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…AF TDM cases in real-life settings (pathogens, underlying diseases, 69,71–73,75,81 trends per year, 84,234,235,236,238,239,241,244,245,344–348 CNS 532–539 localization 541–566 ) 364,370,499,522,527–530 Trends are concerning a majority of mucomycosis and aspergillosis, in oncohematology and transplantation. VRZ, more recently PSZ tablets and ISZ are the most represented.…”

Section: Tdm For Af Drugsmentioning

confidence: 99%

Antifungal Drugs TDM: Trends and Update

Kably

Launay

Derobertmasure

et al. 2022

Therapeutic Drug Monitoring

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The increasing burden of invasive fungal infections results in growing challenges to antifungal (AF) therapeutic drug monitoring (TDM). This review aims to provide an overview of recent advances in AF TDM. Methods:We conducted a PubMed search for articles during 2016-2020 using "TDM" or "pharmacokinetics" or "drug-druginteraction" with "antifungal," consolidated for each AF. Selection was limited to English language articles with human data on drug exposure.Results: More than 1000 articles matched the search terms. We selected 566 publications. The latest findings tend to confirm previous observations in real-life clinical settings. The pharmacokinetic variability related to special populations is not specific but must be considered. AF benefit-to-risk ratio, drug-drug interaction (DDI) profiles, and minimal inhibitory concentrations for pathogens must be known to manage at-risk situations and patients. Itraconazole has replaced ketoconazole in healthy volunteers DDI studies. Physiologically based pharmacokinetic modeling is widely used to assess metabolic azole DDI. AF prophylactic use was studied more for Aspergillus spp. and Mucorales in oncohematology and solid organ transplantation than for Candida (already studied). Emergence of central nervous system infection and severe infections in immunocompetent individuals both merit special attention. TDM is more challenging for azoles than amphotericin B and echinocandins. Fewer TDM requirements exist for fluconazole and isavuconazole (ISZ); however, ISZ is frequently used in clinical situations in which TDM is recommended. Voriconazole remains the most challenging of the AF, with toxicity limiting high-dose treatments. Moreover, alternative treatments (posaconazole tablets, ISZ) are now available.Conclusions: TDM seems to be crucial for curative and/or longterm maintenance treatment in highly variable patients. TDM poses fewer cost issues than the drugs themselves or subsequent treatment issues. The integration of clinical pharmacology into multidisciplinary management is now increasingly seen as a part of patient care.

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Section: Tdm For Af Drugsmentioning

confidence: 99%

Antifungal Drugs TDM: Trends and Update

Kably

Launay

Derobertmasure

et al. 2022

Therapeutic Drug Monitoring

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“…Other medication like isavuconazole was approved by the Food and Drug Administration (FDA) as an antifungal drug for the treatment of invasive mucormycosis infections based on experiment that compared isavuconazole to amphotericin B in the treatment of mucormycosis. 19 The determination between septate (e.g., Aspergillus) and non-septate hyphae (e.g., Mucorales) is of clinical significance, as this strongly affects antifungal treatment. 20 For example respiratory infections in COVID-19 can developed aspergillosis in some patient and Triazole antifungal drugs known as azoles, are the primary treatment for aspergillosis.…”

Section: Histological Featuresmentioning

confidence: 99%

Post COVID -19 Mucormycosis. Review of literature

et al. 2022

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Mucormycosis is a fatal fungal infection which emerges as a serious complication of COVID-19. It increased significantly in prevalence in the last few years especially in immunocompromised patients. Clinically, it has different types, pulmonary mucormycosis, Gastrointestinal tract mucormycosis, renal mucormycosis, Cutaneous mucormycosis, disseminated mucormycosis, but the most common type to develop is Rhino-orbital-cerebral-mucormycosis (ROCM).A fast definitive diagnosis is the most critical step to determine the type of treatment with either a surgical or pharmacological approach and to confine the spread of the infection to neighboring tissues to achieve a better prognosis with reconstruction of affected area and decrease the rate of mortalities. The aim of this review is to discuss mucormycosis based on evidence from 1957 until 2022 taken from different countries, to shine light on causative factor, clinical presentation, radiographic appearance, its classifications and treatment using surgical and pharmacological pathways, also show the recent reconstruction methods performed, as well as its mortality rate.

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“…After exclusion of reports published in non-English language or in which clinical and therapeutic data were not available for the purpose of the present review, a total of 41 cases have been included. Clinical and demographic characteristics, details of the antifungal treatment, outcome and adverse effects reported on these patients are summarized in Table 2 [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 ]. Thirty-three out of 42 (78.5%) patients were male and the mean age was 52 years (range 20–79).…”

Section: Isavuconazole In Non-hematological Patientsmentioning

confidence: 99%