| Contributors: |
Giacobbe, Daniele Roberto; Bartalucci, Claudia; Bavastro, Martina; Schiavoni, Riccardo; Di Pilato, Vincenzo; Muccio, Marco; Signori, Alessio; Aldieri, Chiara; Angelini, Jacopo; Asperges, Erika; Blasi Vacca, Elisabetta; Boffa, Nicoletta; Bono, Enrica; Cacopardo, Bruno; Calabresi, Alessandra; Casarini, Martina; Cattelan, Annamaria; Corcione, Silvia; Cosentino, Federica; De Pascale, Gennaro; De Rosa, Francesco Giuseppe; Del Bono, Valerio; Del Puente, Filippo; Fanelli, Chiara; Fava, Fiorenza; Franceschini, Erica; Geremia, Nichola; Giannella, Maddalena; Giuliano, Simone; Maida, Ivana; Marino, Andrea; Mazzitelli, Maria; Meloni, Maria Chiara; Merli, Marco; Meschiari, Marianna; Moreal, Chiara; Oltolini, Chiara; Pallone, Rita; Panese, Sandro; Pontali, Emanuele; Ricciardetto, Martina; Rinaldi, Matteo; Russo, Alessandro; Sanguinetti, Maurizio; Scaglione, Vincenzo; Serapide, Francesca; Serino, Francesco Saverio; Shbaklo, Nour; Torti, Carlo; Travi, Giovanna; Magnasco, Laura; Portunato, Federica; Briano, Federica; Mikulska, Malgorzata; Ball, Lorenzo; Robba, Chiara; Patroniti, Nicolò; Battaglini, Denise; Giacomini, Mauro; Coppo, Erika; Marchese, Anna; Vena, Antonio; Bassetti, Matteo; Null, Null; Murgia, Ylenia; Di Meco, Gabriele; Cappello, Alice; Guastavino, Sabrina; Campi, Cristina; Piana, Michele; Mora, Sara; Rosso, Nicola; Di Biagio, Antonio; Viglietti, Giulia; Lamarina, Annaflavia; Antola, Stefano; Gallone, Selene; Viale, Pierluigi; Campanella, Edoardo Antonio; Franzò, Alessandro; Gullotta, Chiara; Costarella, Davide; Bruni, Andrea; Garofalo, Eugenio; Longhini, Federico; Boni, Silvia; Tigano, Stefania; Albertini, Maddalena; Chemello, Davide; Santoro, Antonella; Mengato, Daniele; Munari, Martina; Navalesi, Paolo; Tiberio, Ivo; De Benedetto, Ilaria; Lupia, Tommaso; Pinna, Simone Mornese; Ferin, Sara; Flammini, Sarah; Martini, Luca |
| Description: |
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. |