ArticleInfection2011
The efficacy of voriconazole in the treatment of 192 fungal central nervous system infections: a retrospective analysis.
Article in Infection, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Salvage combination antifungal therapy for acute invasive aspergillosis may improve outcomes: a systematic review and meta-analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2014Pooled it
- Treatment of invasive fungal infections in cancer patients-updated recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO).Annals of hematology · 2014Guideline
- Aspergillus meningitis: a rare clinical manifestation of central nervous system aspergillosis. Case report and review of 92 cases.The Journal of infection · 2013Pooled it
- Development Framework of Desirability of Outcome Ranking Endpoints for Use in Clinical Trials of Invasive Fungal Diseases.Open forum infectious diseases · 2026Trial
- Clinical, diagnostic and therapeutic challenges in CNS fungal infections: a single-center retrospective data analysis.Journal of neurology · 2025Article
- Outcomes of Invasive Fungal Infections Treated with Isavuconazole: A Retrospective Review.Pathogens (Basel, Switzerland) · 2024Article
- Breaking the mould: challenging the status quo of clinical trial response definitions for invasive fungal diseases-a debate.The Journal of antimicrobial chemotherapy · 2024Article
- Scedosporiosis and lomentosporiosis: modern perspectives on these difficult-to-treat rare mold infections.Clinical microbiology reviews · 2024Review
- A rare case of cerebral phaeohyphomycosis caused byMedical mycology case reports · 2024Article
- Treatment of Invasive Aspergillosis: How It's Going, Where It's Heading.Mycopathologia · 2023Review
- Challenges in the Treatment of Invasive Aspergillosis in Immunocompromised Children.Antimicrobial agents and chemotherapy · 2022Review
- The Role of Isavuconazonium Sulphate for the Treatment of Blastomycosis: A Case Series and Antifungal Susceptibility.Open forum infectious diseases · 2022Article
- Caspofungin Cerebral Penetration and Therapeutic Efficacy in Experimental Cerebral Aspergillosis.Microbiology spectrum · 2022Article
- Ruptured fungal mycotic internal carotid artery aneurysm successfully treated with stent-assisted coil embolization: A case report.Surgical neurology international · 2022Article
- Intracerebral opportunistic infections caused by immunosuppressants after orthotopic liver transplantation: Report of two cases and literature review.Frontiers in immunology · 2022Review
- Influenza-Associated Disseminated Aspergillosis in a 9-Year-Old Girl Requiring ECMO Support.Journal of fungi (Basel, Switzerland) · 2021Article
- Haemorrhagic cystitis following the administration of voriconazole in the treatment of central nervous system aspergillosis: a case report.The Journal of international medical research · 2020Article
- Isavuconazole for the treatment of patients with invasive fungal diseases involving the central nervous system.Medical mycology · 2020Article
- Antifungal Drugs: Special Problems Treating Central Nervous System Infections.Journal of fungi (Basel, Switzerland) · 2019Article
- Central Nervous System Infections Due to Aspergillus and Other Hyaline Molds.Journal of fungi (Basel, Switzerland) · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe efficacy of voriconazole against fungal central nervous system (CNS) infections was examined retrospectively.
methodsVoriconazole-treated patients with proven (137) or probable (55) CNS infections were identified in the voriconazole database (114) and the literature (78). Investigator-determined success was a complete or partial response. Survival was calculated from the start of voriconazole therapy.
resultsThe patients' age range was <1-81 years (median 43) and 127 (66%) were male. Aspergillus spp. (63%) and Scedosporium spp. (18%) predominated, but 12 other genera were recorded. Underlying conditions were haematopoietic stem cell transplantation (HSCT, 35), haematologic malignancy (HM, 35), solid-organ transplantation (SOT, 25), chronic immunosuppression (CI, 40) and other conditions (OC, 57). The median voriconazole therapy duration was 93 days (range 1-1,128), with success in 93 patients (48%). Only 35 patients received primary therapy, with success in 63% versus 45% for salvage (p = 0.06 NS). Underlying conditions influenced success; HSCT 14%, HM 54%, SOT 40%, CI 45% and OC 72% (p < 0.001). Additional antifungal combination therapy (37 patients) gave a trend towards an improved response rate (p = 0.09) and superior survival (p = 0.0149), while patients receiving neurosurgical interventions (72) showed superior responses (p = 0.0174) and survival (p = 0.0399). In all, 49% of patients died, 71% (67/94) due to fungal infection. The overall median survival was 297 days (range 3 to >2,000). Paediatric (p = 0.014) and literature patients (p < 0.001) exhibited superior survival compared with adults and voriconazole database patients, respectively.
conclusionsVoriconazole shows encouraging efficacy against various CNS fungal infections. Combination therapy and/or CNS surgery may improve outcomes.
Indexed as
Identifiers
21512792What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.