Mold-Active Triazole Antifungals for Prophylaxis in Immunocompromised Patients

In a prospective, multicenter, observational study, use of voriconazole, posaconazole, or isavuconazole yielded a fungal-specific mortality of 6.8% — but the study has important limitations.

Invasive fungal disease (IFD) among immunocompromised hosts has an estimated mortality of 40% to 80%. Accordingly, many centers use the mold-active triazole antifungals (MATs) voriconazole, posaconazole, and isavuconazole for prophylaxis. To ascertain the real-world practical experience with this approach, researchers queried a multicenter, prospective registry at 55 U.S. sites.

Among 1177 patients who received prophylaxis between March 2017 and April 2020, 76.5% had a hematologic malignancy. Of the 1030 who were assessed, 7.1% developed a breakthrough IFD (bIFD); these were evenly distributed among all three antifungals. Candida (36.1%) and Aspergillus (29.5%) caused most bIFDs. Mucorales infection occurred in three subjects, all of whom ha…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Mold-Active Triazole Antifungals for Prophylaxis in Immunocompromised Patients

Topics

Reviewing Author