Use of isavuconazole in critically ill patients in intensive care units: a prospective, observational, multicentre, cohort study.

IF 3.3 Q2 INFECTIOUS DISEASES

JAC-Antimicrobial Resistance Pub Date : 2025-10-06 eCollection Date: 2025-10-01 DOI:10.1093/jacamr/dlaf177

Daniele Roberto Giacobbe, Claudia Bartalucci, Martina Bavastro, Riccardo Schiavoni, Vincenzo Di Pilato, Marco Muccio, Alessio Signori, Chiara Aldieri, Jacopo Angelini, Erika Asperges, Elisabetta Blasi Vacca, Nicoletta Boffa, Enrica Bono, Bruno Cacopardo, Alessandra Calabresi, Martina Casarini, Annamaria Cattelan, Silvia Corcione, Federica Cosentino, Gennaro De Pascale, Francesco Giuseppe De Rosa, Valerio Del Bono, Filippo Del Puente, Chiara Fanelli, Fiorenza Fava, Erica Franceschini, Nicholas Geremia, Maddalena Giannella, Simone Giuliano, Ivana Maida, Andrea Marino, Maria Mazzitelli, Maria Chiara Meloni, Marco Merli, Marianna Meschiari, Chiara Moreal, Chiara Oltolini, Rita Pallone, Sandro Panese, Emanuele Pontali, Martina Ricciardetto, Matteo Rinaldi, Alessandro Russo, Maurizio Sanguinetti, Vincenzo Scaglione, Francesca Serapide, Francesco Saverio Serino, Nour Shbaklo, Carlo Torti, Giovanna Travi, Laura Magnasco, Federica Portunato, Federica Briano, Malgorzata Mikulska, Lorenzo Ball, Chiara Robba, Nicolò Patroniti, Denise Battaglini, Mauro Giacomini, Erika Coppo, Anna Marchese, Antonio Vena, Matteo Bassetti

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引用次数: 0

Abstract

Objectives: In this multicentre, prospective study, we aimed to describe the use of isavuconazole in critically ill adult patients in ICU, in terms of patient characteristics, infection characteristics and outcomes.

Methods: Prospective, observational study of ICU patients treated with isavuconazole from January 2023 to 30 April 2025 in 17 centres (ISA-SITA study within the MULTI-SITA project).

Results: A total of 177 ICU patients treated with isavuconazole were included in the study. Most patients showed at least one European Organisation for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) or FUNgal Diseases in adult patients in Intensive Care Unit (FUNDICU) host factor (141/177, 79.7%). Overall, 82/177 patients (46.3%) had either proven or probable invasive mould disease (6 and 76, respectively, mostly invasive pulmonary aspergillosis). In patients with proven or probable disease, 30-day mortality was 44.0%, and 90-day mortality was 62.2%. In multivariable analyses, SOFA score (HR 1.14 per one point increase, 95% CI 1.03-1.26, P = 0.010) and concomitant bacterial pneumonia (HR 2.32, 95% CI 1.17-4.59, P = 0.016) were associated with 30-day mortality, whereas prior hospitalization (HR 2.26, 95% CI 1.19-4.27, P = 0.013) and SOFA score (HR 1.17 per one point increase, 95% CI 1.07-1.28, P < 0.001) were associated with 90-day mortality.

Conclusions: Diverse patterns of isavuconazole use were observed in a large cohort of critically ill adult patients, and the drug was well tolerated. Mortality was lower than many previous estimates in critically ill patients and could serve as a basis for future standardized comparisons.

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重症监护病房危重病人使用异唑康唑：一项前瞻性、观察性、多中心、队列研究

目的：在这项多中心前瞻性研究中，我们旨在从患者特征、感染特征和结局方面描述isavuconazole在ICU重症成人患者中的使用情况。方法：对2023年1月至2025年4月30日在17个中心接受isavuconazole治疗的ICU患者进行前瞻性观察研究（多sita项目中的ISA-SITA研究）。结果：本研究共纳入177例使用异舒康唑治疗的ICU患者。大多数患者至少有一种欧洲癌症研究与治疗组织/真菌研究小组教育和研究联盟（EORTC/MSGERC）或重症监护病房（FUNDICU）成年患者真菌疾病宿主因子（141/177,79.7%）。总体而言，177例患者中有82例（46.3%）证实或可能患有侵袭性霉菌病（分别为6例和76例，主要是侵袭性肺曲霉病）。在确诊或可能患病的患者中，30天死亡率为44.0%，90天死亡率为62.2%。在多变量分析中，SOFA评分（HR 1.14每增加1分，95% CI 1.03-1.26, P = 0.010）和合并细菌性肺炎（HR 2.32, 95% CI 1.17-4.59, P = 0.016）与30天死亡率相关，而先前住院（HR 2.26, 95% CI 1.19-4.27, P = 0.013）和SOFA评分(HR 1.17每增加1分，95% CI 1.07-1.28， P。在一大批危重成人患者中观察到不同的异唑康唑使用模式，并且该药耐受性良好。危重病人的死亡率低于许多以前的估计，可以作为未来标准化比较的基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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