Activities of voriconazole, itraconazole and amphotericin B in vitro against 590 moulds from 323 patients in the voriconazole Phase III clinical studies

Espinel-Ingroff, Ana; Johnson, Elizabeth; Hockey, Hans; Troke, Peter F.

doi:10.1093/jac/dkm518

Cited by 87 publications

(45 citation statements)

References 27 publications

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“…Novel systems for detection of circulating fungal cell wall markers and/or DNA in blood and other body fl uids or in affecting tissues may improve the laboratory diagnosis of disseminated aspergillosis (15,23). Our results of in vitro resistance to amphotericin B and susceptibility to voriconazole were comparable with the published data on in vitro activities of these antifungal agents for 13 worldwide clinical A. nidulans isolates from different body sites including brain/CSF (24). Poor response and high failure rates have been reported in patients with A. nidulans cerebral infection who were treated with amphotericin B (21).…”

Section: Casesupporting

confidence: 82%

Two Rare Cases Of Central Nervous System Opportunistic Mycoses / Oportunističke Mikoze Središnjega Živčanog Sustava – Prikaz Dvaju Bolesnika

Missoni¹,

Baršić

2012

Archives of Industrial Hygiene and Toxicology

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This article presents two cases of opportunistic mycoses (OMs) of the central nervous system (CNS) caused by Cryptococcus neoformans and Aspergillus nidulans, respectively. The patients were hospitalised in local hospitals between 2009 and 2011 because of unspecifi c symptoms (fever, headache, and/or weight lost). Duration of symptoms varied from 4 days to over 2 weeks. The patients were treated with antibiotics and symptomatically. OM was not suspected in any of them. The patients became critically ill with symptoms of CNS involvement and were transferred to the Intensive Care Unit (ICU) of the University Hospital for Infectious diseases (UHID) in Zagreb. None of the patients belonged to the high-risk population for developing OMs. They were not HIV-infected, had no transplantation of bone marrow or solid organ, and were not on severe immunosuppressive chemotherapy. Fungi were isolated from cerebrospinal fl uid (CSF) samples and, in one patient, from aspirate of cerebral abscess. Isolation and mycological identifi cation of all fungal isolates and in vitro antifungal susceptibility testing of these isolates were done at the Reference Centre for Mycological Diagnostics of Systemic and Disseminated Infections (RCMDSDI) in Zagreb. The patient with cryptococcal meningitis was treated with amphotericin B and fl uconazole and the patient with cerebral aspergilloma with voriconazole.

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Section: Casesupporting

confidence: 82%

Two Rare Cases Of Central Nervous System Opportunistic Mycoses / Oportunističke Mikoze Središnjega Živčanog Sustava – Prikaz Dvaju Bolesnika

Missoni¹,

Baršić

2012

Archives of Industrial Hygiene and Toxicology

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“…; 32,33 furthermore, it possesses potent in vitro activity against a wide range of other molds. 12 Voriconazole is available in both oral and intravenous formulations, which allows continuation of therapy in patients who have difficulty in swallowing (due to © F e r r a t a S t o r t i F o u n d a t i o n severe mucositis, for example) and can, therefore, cover the entire risk period of invasive fungal infections in HSCT patients, unlike other azoles that are only available as oral formulations. The availability of oral voriconazole makes the agent convenient for outpatient use, for example, in patients recovering from neutropenia.…”

Section: Discussionmentioning

confidence: 99%

“…10 Voriconazole is a broad-spectrum second-generation triazole, available in both oral and intravenous formulations, with potent activity against a wide variety of clinically significant molds and yeasts. 11,12 In a large, prospective, randomized trial, voriconazole was shown to provide a significant survival benefit, as well as superior efficacy and safety, over amphotericin B as first-line treatment of proven or probable invasive aspergillosis. 13 Furthermore, exploratory studies have shown that voriconazole is effective as secondary prophylaxis of invasive fungal infections in leukemia patients and HSCT recipients.…”

Section: Introductionmentioning

confidence: 99%

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Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study

Cordonnier¹,

Rovira²,

Maertens³

et al. 2010

Haematologica

125

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A complete list of the members of the VOSIFI Study Group is provided in the Appendix. BackgroundRecurrence of prior invasive fungal infection (relapse rate of 30-50%) limits the success of stem cell transplantation. Secondary prophylaxis could reduce disease burden and improve survival. Design and MethodsA prospective, open-label, multicenter trial was conducted evaluating voriconazole (4 mg/kg/12 h intravenously or 200 mg/12 h orally) as secondary antifungal prophylaxis in allogeneic stem cell transplant recipients with previous proven or probable invasive fungal infection. Voriconazole was started 48 h or more after completion of conditioning chemotherapy and was planned to be continued for 100-150 days. Patients were followed for 12 months. The primary end-point of the study was the incidence of proven or probable invasive fungal infection. ResultsForty-five patients were enrolled, 41 of whom had acute leukemia. Previous invasive fungal infections were proven or probable aspergillosis (n=31), proven candidiasis (n=5) and other proven or probable infections (n=6); prior infection could not be confirmed in three patients. The median duration of voriconazole prophylaxis was 94 days. Eleven patients (24%) died within 12 months of transplantation, but only one due to systemic fungal disease. Three invasive fungal infections occurred post-transplant: two relapses (one candidemia and one fatal scedosporiosis) and one new zygomycosis in a patient with previous aspergillosis. The 1-year cumulative incidence of invasive fungal disease was 6.7±3.6%. Two patients were withdrawn from the study due to treatment-related adverse events (i.e. liver toxicity). ConclusionsVoriconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after allogeneic stem cell transplantation. The observed incidence of 6.7% (with one attributable death) is considerably lower than the relapse rate reported in historical controls, thus suggesting that voriconazole is a promising prophylactic agent in this population. (ClinicalTrials.gov identifier: NCT00143312). © F e r r a t a S t o r t i F o u n d a t i o n

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“…[15][16][17] Voriconazole (VRCZ), from a newer generation of triazoles, has also potent anti-aspergillus activity in vivo and in vitro. 18,19 Our study is the first prospective large-scale trial comparing intravenous MCFG and intravenous VRCZ as induction therapy in CPA patients who require immediate treatment.…”

Section: Introductionmentioning

confidence: 99%

Intravenous micafungin versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan

Kohno

Izumikawa

Ogawa

et al. 2010

Journal of Infection

108

129

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SUMMARYChronic pulmonary aspergillosis (CPA) is slowly progressive inflammatory pulmonary syndrome due to Aspergillus spp. The evidence regarding CPA treatment is limited. We conducted a randomized, multicenter, open-label trial comparing intravenous micafungin (MCFG) of 150-300 mg once daily with intravenous voriconazole (VRCZ) of 6 mg/kg twice on Day 1 followed by 4 mg/kg twice daily for the treatment of 107 inpatients with CPA to compare the efficacy and safety of both drugs as initial treatment in Japan.

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Activities of voriconazole, itraconazole and amphotericin B in vitro against 590 moulds from 323 patients in the voriconazole Phase III clinical studies

Cited by 87 publications

References 27 publications

Two Rare Cases Of Central Nervous System Opportunistic Mycoses / Oportunističke Mikoze Središnjega Živčanog Sustava – Prikaz Dvaju Bolesnika

Two Rare Cases Of Central Nervous System Opportunistic Mycoses / Oportunističke Mikoze Središnjega Živčanog Sustava – Prikaz Dvaju Bolesnika

Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study

Intravenous micafungin versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan

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