Universität zu Köln

Jenks, J. D., Seidel, D., Cornely, O. A., Chen, S., van Hal, S., Kauffman, C., Miceli, M. H., Heinemann, M., Christner, M., Jover Saenz, A., Burchardt, A., Kemmerling, B., Herbrecht, R., Steinmann, J., Shoham, S., Graeber, S., Pagano, L., Deeren, D., Aslam, S., Taplitz, R., Revankar, S. G., Baddley, J., Mehta, S. R., Reed, S., Slavin, M. A. and Hoenigl, M. (2020). Voriconazole plus terbinafine combination antifungal therapy for invasive Lomentospora prolificans infections: analysis of 41 patients from the FungiScope (R) registry 2008-2019. Clin. Microbiol. Infect., 26 (6). OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

Objectives: Lomentospora prolificans is an emerging cause of serious invasive fungal infections. Optimal treatment of these infections is unknown, although voriconazole-containing treatment regimens are considered the treatment of choice. The objective of this study was to evaluate the role of combination antifungal therapy for L. prolificans infections. Methods: We performed a retrospective review of medical records of patients with invasive L. prolificans infection diagnosed between 1 January 2008 and 9 September 2019 that were documented in the FungiScope (R) registry of rare invasive fungal infections. We compared clinical outcomes between antifungal treatment strategies. Results: Over the study period, 41 individuals with invasive L. prolificans infection from eight different countries were documented in the FungiScope (R) registry. Overall, 17/40 (43%) had treatment response/ stable disease and 21/40 (53%) had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was associated with increased 28-day survival (15/24 survived versus 4/16 receiving monotherapy; p 0.027) and the combination voriconazole plus terbinafine trended to be associated with higher rates of treatment success (10/16, 63%, 95% CI 35%-85%) compared with other antifungal treatment regimens (7/24, 29%, 95% CI 13%-51%, p 0.053). In Kaplan-Meier survival analysis there was a higher survival probability in individuals receiving the voriconazole/terbinafine combination compared with other antifungal regimens (median survival 150 days versus 17 days). Conclusions: While overall mortality was high, combination antifungal treatment, and in particular combination therapy with voriconazole plus terbinafine may be associated with improved treatment outcomes compared with other antifungal regimens for the treatment of invasive L. prolificans infections. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jenks, J. D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seidel, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Hal, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kauffman, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Miceli, M. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinemann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Christner, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jover Saenz, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burchardt, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kemmerling, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbrecht, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinmann, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shoham, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Graeber, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pagano, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Deeren, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Aslam, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Taplitz, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Revankar, S. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baddley, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehta, S. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reed, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Slavin, M. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-332119
DOI:	10.1016/j.cmi.2020.01.012
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	26
Number:	6
Date:	2020
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AGENTS Multiple languages Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33211