Salvage therapy with voriconazole for invasive fungal infections in patients failing or intolerant to standard antifungal therapy.

摘要: Background. Invasive fungal infections (IFI), particularly those caused by Aspergillus and other angioinvasive molds, are associated with an excessive mortality despite therapy. Methods. Voriconazole was prescribed on a compassionate basis to patients IFI who were intolerant or had progressed standard Outcome determined protocol-based criteria as established the consensus definitions (complete response [CR], partial [PR], stable disease, failure, intolerance). Results. Forty-five enrolled in release program (29 [64%] because of failure therapy), between 1998 2002. Of 45 enrolled, 35 (78%) invasive Aspergillus, 3 (7%) Fusarium, 2 (4%) Scedosporium infections. Underlying illnesses follows: 13 (29%) solid-organ transplant (SOT), 11 (24%) BMT, 7 (13%) hematologic malignancy. Site infection 26 (58%) pulmonary, 9 (20%) disseminated, 5 (11%) central nervous system (CNS), sinus. Overall rates CR, 17 (38%) PR, 15 (33%) 4 (9%) intolerant. Seven eight (88%) sinus CNS disease demonstrated stabilization IFI. The median duration voriconazole therapy 79 days receiving over 1 year Nine thousand one hundred twenty-eight given only four serious adverse events two cases considered possibly probably drug related. Conclusions. In this population severely immuno-compromised life-threatening have failed antifungal therapy, substantial efficacy acceptable level toxicity.