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Treatment of scedosporiosis with voriconazole: clinical experience with 107 patients.

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... Full description

Journal Title: Antimicrobial agents and chemotherapy May 2008, Vol.52(5), pp.1743-1750
Main Author: Troke, Peter
Other Authors: Aguirrebengoa, Koldo , Arteaga, Carmen , Ellis, David , Heath, Christopher H , Lutsar, Irja , Rovira, Montserrat , Nguyen, Quoc , Slavin, Monica , Chen, Sharon C A , Troke, Peter
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1098-6596 ; DOI: 1098-6596 ; DOI: 10.1128/AAC.01388-07
Link: http://search.proquest.com/docview/69137423/?pq-origsite=primo
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title: Treatment of scedosporiosis with voriconazole: clinical experience with 107 patients.
format: Article
creator:
  • Troke, Peter
  • Aguirrebengoa, Koldo
  • Arteaga, Carmen
  • Ellis, David
  • Heath, Christopher H
  • Lutsar, Irja
  • Rovira, Montserrat
  • Nguyen, Quoc
  • Slavin, Monica
  • Chen, Sharon C A
  • Troke, Peter
subjects:
  • Adolescent–Therapeutic Use
  • Adult–Drug Therapy
  • Aged–Microbiology
  • Aged, 80 and Over–Pathology
  • Antifungal Agents–Statistics & Numerical Data
  • Aspergillosis–Therapeutic Use
  • Child–Drug Effects
  • Child, Preschool–Therapeutic Use
  • Clinical Trials As Topic–Therapeutic Use
  • Female–Therapeutic Use
  • Health Surveys–Therapeutic Use
  • Humans–Therapeutic Use
  • Infant–Therapeutic Use
  • Male–Therapeutic Use
  • Middle Aged–Therapeutic Use
  • Pyrimidines–Therapeutic Use
  • Scedosporium–Therapeutic Use
  • Treatment Outcome–Therapeutic Use
  • Triazoles–Therapeutic Use
  • Voriconazole–Therapeutic Use
  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole
ispartof: Antimicrobial agents and chemotherapy, May 2008, Vol.52(5), pp.1743-1750
description: 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.
language: eng
source:
identifier: E-ISSN: 1098-6596 ; DOI: 1098-6596 ; DOI: 10.1128/AAC.01388-07
fulltext: fulltext
issn:
  • 10986596
  • 1098-6596
url: Link


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titleTreatment of scedosporiosis with voriconazole: clinical experience with 107 patients.
creatorTroke, Peter ; Aguirrebengoa, Koldo ; Arteaga, Carmen ; Ellis, David ; Heath, Christopher H ; Lutsar, Irja ; Rovira, Montserrat ; Nguyen, Quoc ; Slavin, Monica ; Chen, Sharon C A ; Troke, Peter
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subjectAdolescent–Therapeutic Use ; Adult–Drug Therapy ; Aged–Microbiology ; Aged, 80 and Over–Pathology ; Antifungal Agents–Statistics & Numerical Data ; Aspergillosis–Therapeutic Use ; Child–Drug Effects ; Child, Preschool–Therapeutic Use ; Clinical Trials As Topic–Therapeutic Use ; Female–Therapeutic Use ; Health Surveys–Therapeutic Use ; Humans–Therapeutic Use ; Infant–Therapeutic Use ; Male–Therapeutic Use ; Middle Aged–Therapeutic Use ; Pyrimidines–Therapeutic Use ; Scedosporium–Therapeutic Use ; Treatment Outcome–Therapeutic Use ; Triazoles–Therapeutic Use ; Voriconazole–Therapeutic Use ; Antifungal Agents ; Pyrimidines ; Triazoles ; Voriconazole
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descriptionThe 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.
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29Baclet, V
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31Jabado, A
32Metge, F
33Milpied, N
34Senneville, E
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36Faetkenheuer, G
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38Gotti, E
39Heuvel-Elbrink, M
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68Rajf, S
69Rickman, L
70Rubin, R
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72van Burik, J-A
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titleTreatment of scedosporiosis with voriconazole: clinical experience with 107 patients.
authorTroke, Peter ; Aguirrebengoa, Koldo ; Arteaga, Carmen ; Ellis, David ; Heath, Christopher H ; Lutsar, Irja ; Rovira, Montserrat ; Nguyen, Quoc ; Slavin, Monica ; Chen, Sharon C A ; Troke, Peter
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8Clinical Trials As Topic–Therapeutic Use
9Female–Therapeutic Use
10Health Surveys–Therapeutic Use
11Humans–Therapeutic Use
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13Male–Therapeutic Use
14Middle Aged–Therapeutic Use
15Pyrimidines–Therapeutic Use
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2Arteaga, Carmen
3Ellis, David
4Heath, Christopher H
5Lutsar, Irja
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8Slavin, Monica
9Chen, Sharon C A
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11Dalla Poza, L
12de Witt, D
13Dyer, J
14Franklin, C
15Flexman, J
16Gottlieb, T
17Georghiou, P
18Gordon, D
19Henry, R
20Johnson, B
21Korman, T
22Marriott, D
23Malouf, M
24Mijch, A
25Morton, J
26Palasanthrian, P
27Playford, G
28Rowlands, K
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34Whitby, M
35Bricteux, G
36Jacob, F
37Phillips, P
38Barriga, F
39Baclet, V
40Crevon, L
41Jabado, A
42Metge, F
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44Senneville, E
45Bertz, H
46Faetkenheuer, G
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48Gotti, E
49Heuvel-Elbrink, M
50Rusheed, A
51Bastida-Nila, P
52Bouza, E
53Delgado, A
54Ferra, C
55Martinez-Montauti, J
56Monfa, J
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70Fisher, R
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71Tebas, P
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atitleTreatment of scedosporiosis with voriconazole: clinical experience with 107 patients.
jtitleAntimicrobial agents and chemotherapy
risdate20080501
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