■胚芽属,芽生菌病的病因,是需要长期抗真菌治疗的地方性双态真菌,这可能是复杂的药物不良反应。Isavuconazoniumsulfate(ISA)是一种三唑,在体外和体内对胚芽属植物具有活性,但缺乏临床数据支持其用于芽生菌病的治疗。
■该回顾性病例系列确定了2015年至2019年间在威斯康星大学至少部分接受ISA治疗的14例芽生菌病患者。记录治疗持续时间和结果。此外,在2004年至2017年之间,对29株胚芽菌属的临床分离株进行了对ISA和其他抗真菌药的最低抑制浓度测试。
■14例患者的ISA治疗中位数为255天,占总治疗的68%。一半(14人中有7人)的患者免疫功能低下,14例中有11例(79%)被证实为胚真菌病,14人中有7人(50%)受累于中枢神经系统(CNS),14人中有11人(79%)治愈。抗真菌药敏试验显示,ISA≤0.015mcg/mL的最低抑菌浓度始终较低。
■本病例系列支持ISA治疗有或没有中枢神经系统播散的胚真菌病的疗效和安全性,特别是当不能使用替代三唑时。
UNASSIGNED: Blastomyces spp, the etiologic agents of blastomycosis, are endemic dimorphic fungi that require prolonged antifungal therapy, which can be complicated by adverse drug effects. Isavuconazonium sulphate (ISA) is a triazole with in vitro and in vivo activity against Blastomyces spp, but there is a paucity of clinical data supporting its use for treatment of blastomycosis.
UNASSIGNED: This retrospective case series identified 14 patients with blastomycosis at least partially treated with ISA at the University of Wisconsin between 2015 and 2019. Treatment duration and outcomes were documented. In addition, 29 clinical isolates of Blastomyces spp between 2004 and 2017 were tested for minimum inhibitory concentrations against ISA and other antifungals.
UNASSIGNED: Fourteen patients were treated with a median of 255 days of ISA accounting for 68% of total therapy. Half (7 of 14) of the patients were immunocompromised, 11 of 14 (79%) were proven cases of blastomycosis, 7 of 14 (50%) had central nervous system (CNS) involvement, and 11 of 14 (79%) were cured. Antifungal susceptibility testing showed a consistently low minimum inhibitory concentration to ISA ≤ 0.015 mcg/mL.
UNASSIGNED: This case series supports the efficacy and safety for ISA in the treatment of blastomycosis with or without CNS disseminated, especially when alternative triazoles cannot be used.