The outcomes for 73 invasive fusariosis patients treated with
voriconazole were investigated. Patients with proven (
n = 67)
or probable (
n = 6) infections were identified from the voriconazole
clinical database (
n = 39) and the French National Reference
Center for Mycoses and Antifungals database (
n = 34). Investigator-determined
success was a complete or partial response. Survival was determined
from day 1 of voriconazole therapy to the last day known alive.
Patients were 2 to 79 years old (median, 43 years), and 66%
were male. Identified
Fusarium species (62%) were
F. solani,
F. moniliforme,
F. proliferatum, and
F. oxysporum. Underlying
conditions analyzed included hematopoietic stem cell transplant
(HSCT; 18%), hematologic malignancy (HM; 60%), chronic immunosuppression
(CI; 12%), or other condition (OC; 10%). Infection sites were
brain (5%), disseminated excluding brain (67%), lungs/sinus
(15%), and other (12%). Most patients (64%) were or had recently
been neutropenic (<500 cells/mm
3). Therapy duration was 1
to 480 days (median, 57 days), with a 47% success rate. Baseline
neutropenia impacted success adversely (
P 
0.03). Success varied
by underlying condition (HSCT, 38%; HM, 45%; CI, 44%; OC, 71%)
and infection site (brain, 0%; disseminated, 45%; other, 56%;
lung/sinus, 64%) (
P > 0.05). Combination therapy (13 patients)
was no better than treatment with voriconazole alone. Overall,
59% of the patients died (49% died of fusariosis), and 90-day
survival was 42%. Site of infection influenced survival (
P =
0.02). Median survival (in days) by species was as follows:
F. solani, 213;
F. oxysporum, 112;
Fusarium spp., 101;
F. proliferatum,
84;
F. moniliforme, 76. We conclude that voriconazole is a therapeutic
option for invasive fusariosis.
Antimicrobial Agents and Chemotherapy, October 2010, p. 4446-4450, Vol. 54, No. 10
0066-4804/10/$12.00+0 doi:10.1128/AAC.00286-10
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