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.
Use of isavuconazole in critically ill patients in intensive care units: a prospective, observational, multicentre, cohort study / Giacobbe, Dr; Bartalucci, C; Bavastro, M; Schiavoni, R; Di Pilato, V; Muccio, M; Signori, A; Aldieri, C; Angelini, J; Asperges, E; Blasi Vacca, E; Boffa, N; Bono, E; Cacopardo, B; Calabresi, A; Casarini, M; Cattelan, A; Corcione, S; Cosentino, F; De Pascale, G; De Rosa, Fg; Del Bono, V; Del Puente, F; Fanelli, C; Fava, F; Franceschini, E; Geremia, N; Giannella, M; Giuliano, S; Maida, I; Marino, A; Mazzitelli, M; Meloni, Mc; Merli, M; Meschiari, M; Moreal, C; Oltolini, C; Pallone, R; Panese, S; Pontali, E; Ricciardetto, M; Rinaldi, M; Russo, A; Sanguinetti, M; Scaglione, V; Serapide, F; Serino, Fs; Shbaklo, N; Torti, C; Travi, G; Magnasco, L; Portunato, F; Briano, F; Mikulska, M; Ball, L; Robba, C; Patroniti, N; Battaglini, D; Giacomini, M; Coppo, E; Marchese, A; Vena, A; Bassetti, M. - In: JAC-ANTIMICROBIAL RESISTANCE. - ISSN 2632-1823. - (2025). [10.1093/jacamr/dlaf177]
Use of isavuconazole in critically ill patients in intensive care units: a prospective, observational, multicentre, cohort study
Fanelli C;Maida I
;
2025-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
