@article{25e177eab7004f1e869939aa0fd0cdb6,
title = "Improvement in the outcome of invasive fusariosis in the last decade",
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.",
keywords = "Epidemiology, Fusariosis, Outcome, Treatment, Voriconazole",
author = "M. Nucci and Marr, {K. A.} and Vehreschild, {M. J.G.T.} and {de Souza}, {C. A.} and E. Velasco and P. Cappellano and F. Carlesse and F. Queiroz-Telles and Sheppard, {D. C.} and A. Kindo and S. Cesaro and N. Hamerschlak and C. Solza and Heinz, {W. J.} and M. Schaller and A. Atalla and S. Arikan-Akdagli and H. Bertz and {Galv{\~a}o Castro}, C. and R. Herbrecht and M. Hoenigl and G. H{\"a}rter and Hermansen, {N. E.U.} and A. Josting and L. Pagano and Salles, {M. J.C.} and Mossad, {S. B.} and D. Ogunc and Pasqualotto, {A. C.} and V. Araujo and Troke, {P. F.} and O. Lortholary and Cornely, {O. A.} and E. Anaissie",
note = "Funding Information: Fungiscope is supported by unrestricted grants from Astellas Pharma, Gilead Sciences, MSD/Merck, and Pfizer Pharma GmbH. However, these companies do not have any influence on data collection, analysis, or publication. Funding Information: MN: consultant to Astellas, Merck, Pfizer and Gilead, research grants from Merck and Pfizer; KAM: consultant to Astellas, Merck, and Pfizer, research grants from Astellas, Merck, Pfizer and Sigma Tau; MJGTV: lecture honoraria from Merck, Pfizer, and Gilead Sciences, research grant from 3M; FQT: lecture honoraria from Pfizer, Astellas and Merck; DCS: funding from the Canadian Institutes of Health Research, support from the Fonds de Recherche en Sant{\'e} du Quebec, research grants from Merck, consultant and lecture honoraria from Merck, Pfizer and Astellas; SC: lecture honoraria from Merck and consultant to Gilead and Pfizer; WJH: research grant from Astellas, Basilea, Gilead, Merck and Pfizer, consultant to Merck, and Pfizer, and lecture honoraria from Gilead, Merck and Pfizer; SAA: research grant from Pfizer and lecture honoraria from Merck and Pfizer; HB: research grants from Gilead and consultant to Merck and ESSEX; RH: consultant to Astellas, Basilea, Gilead, Merck and Pfizer, lecture honoraria from Pfizer, Gilead, Merck, research grants from Pfizer; MH: research grants and lecture honoraria from Astellas and Merck; LP: lecture honoraria from Gilead, Merck, Pfizer and Astellas; ACP: research grants and lecture honoraria from Pfizer, Gilead, Merck and Astellas; PFT was previously an employee of and subsequently a consultant to Pfizer; OL: research grants from Merck, consultant to Merck, Astellas and Gilead, and lecture honoraria from Gilead; OC: support from the German Federal Ministry of Research and Education, research grants from 3M, Actelion, Astellas, Basilea, Bayer, Biocryst, Celgene, Cubist, F2G, Genzyme, Gilead, GSK, Merck, Miltenyi, Optimer, Pfizer, Quintiles, and Viropharma, consultant to 3M, Astellas, Basilea, Cubist, F2G, Gilead, GSK, Merck, Optimer and Pfizer, and lecture honoraria from Astellas, Gilead, Merck and Pfizer. CAS, EV, PC, FC, AK, NH, CS, MS, AA, CGCJr, GH, NEUH, AJ, MJCS, SBM, DO, VA, EA: no conflicts.",
year = "2014",
month = jun,
doi = "10.1111/1469-0691.12409",
language = "English (US)",
volume = "20",
pages = "580--585",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier Limited",
number = "6",
}