Comparison of Posaconazole Versus Voriconazole in the Induction of Acute Myeloid Leukemia: Impact on Cost, Safety, and Efficacy

Antosz, Olivia; Peyton-Thomas, Breanne; Selby, Christopher; Bozeman, Amy; Leary, Cheri; Devarakonda, Srinivas; Mansour, Richard; Mills, Glenn; Koshy, Nebu

doi:10.1016/j.bbmt.2016.12.505

Cited by 2 publications

(1 citation statement)

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“…While echinocandins are well tolerated, their use is recommended only in cases of salvage therapy or intolerance of other first line agents. Posaconazole and isavuconazonium are viable alternatives for treatment but are more expensive [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Missed Opportunities for Antifungal Stewardship during the COVID-19 Era

Hawkins,

Walker,

Shorman

2023

Antibiotics

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Significant increases in antibacterial use were observed during the COVID-19 pandemic. However, subsequent analyses found this increase in antibiotic use to be excessive in comparison with the relatively low rates of bacterial coinfection. Although patients who are critically ill with COVID-19 may be at an increased risk for pulmonary aspergillosis, antifungal use in these populations remained underreported, particularly in later phases of the pandemic. This single-center, population-level cohort analysis compares the monthly use rates of mold-active antifungal drugs in the medical intensive care unit during April 2019–March 2020 (baseline) with those during April 2020–November 2022. The antifungal drugs included in the analysis were liposomal amphotericin B, anidulafungin, isavuconazonium, posaconazole, and voriconazole. We found that during 2020–2022, the usage of antifungal drugs was not significantly different from baseline for all included agents except isavuconazonium, which was used significantly more (p = 0.009). There were no changes in diagnostic modalities between the two time periods. The reported prevalence of and mortality from COVID-19-associated pulmonary aspergillosis (CAPA) may have resulted in higher rates of prescribing antifungal drugs for critically ill patients with COVID-19. Antimicrobial stewardship programs should develop and apply tools to facilitate more effective and appropriate antifungal use.

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Section: Discussionmentioning

confidence: 99%