Please use this identifier to cite or link to this item:
Type: Artigo
Title: Improvement in the outcome of invasive fusariosis in the last decade
Author: Nucci, M.
Marr, K. A.
Vehreschild, M. J. G. T.
de Souza, C. A.
Velasco, E.
Cappellano, P.
Carlesse, F.
Queiroz-Telles, F.
Sheppard, D. C.
Kindo, A.
Cesaro, S.
Hamerschlak, N.
Solza, C.
Heinz, W. J.
Schaller, M.
Atalla, A.
Arikan-Akdagli, S.
Bertz, H.
Galvão Castro, C.
Herbrecht, R.
Hoenigl, M.
Härter, G.
Hermansen, N. E. U.
Josting, A.
Pagano, L.
Salles, M. J. C.
Mossad, S. B.
Ogunc, D.
Pasqualotto, A. C.
Araujo, V.
Troke, P. F.
Lortholary, O.
Cornely, O. A.
Anaissie, E.
Abstract: Invasive fusariosis (IF) has been associated with a poor prognosis. Although recent series have reported improved outcomes, the definition of optimal treatments remains controversial. The objective of this study was to evaluate changes in the outcome of IF. We retrospectively analysed 233 cases of IF from 11 countries, comparing demographics, clinical findings, treatment and outcome in two periods: 1985–2000 (period 1) and 2001–2011 (period 2). Most patients (92%) had haematological disease. Primary treatment with deoxycholate amphotericin B was more frequent in period 1 (63% vs. 30%, p <0.001), whereas voriconazole (32% vs. 2%, p <0.001) and combination therapies (18% vs. 1%, p <0.001) were more frequent in period 2. The 90-day probabilities of survival in periods 1 and 2 were 22% and 43%, respectively (p <0.001). In period 2, the 90-day probabilities of survival were 60% with voriconazole, 53% with a lipid formulation of amphotericin B, and 28% with deoxycholate amphotericin B (p 0.04). Variables associated with poor prognosis (death 90 days after the diagnosis of fusariosis) by multivariable analysis were: receipt of corticosteroids (hazard ratio (HR) 2.11, 95% CI 1.18–3.76, p 0.01), neutropenia at end of treatment (HR 2.70, 95% CI 1.57–4.65, p <0.001), and receipt of deoxycholate amphotericin B (HR 1.83, 95% CI 1.06–3.16, p 0.03). Treatment practices have changed over the last decade, with an increased use of voriconazole and combination therapies. There has been a 21% increase in survival rate in the last decade
Subject: Voriconazol
Country: Reino Unido
Editor: Elsevier
Rights: Fechado
Identifier DOI: 10.1111/1469-0691.12409
Date Issue: 2014
Appears in Collections:HEMO - Artigos e Outros Documentos

Files in This Item:
File Description SizeFormat 
2-s2.0-84904434174.pdf5.77 MBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.