Evidence map›Paper›PMID 42332231›Full record

ArticleInfectious diseases and therapy2026

Use of Isavuconazole in the Treatment of Cryptococcosis: A Real-World Case Series.

Marta Albanell-Fernández, Andrea Vergara, Ana Martinez-Urrea, Carolina Garcia-Vidal, Marta Ulldemolins, Josep Mensa, Álex Soriano, Marta Bodro

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Article in Infectious diseases and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Marta Albanell-FernándezPharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. malbanell@clinic.cat.ORCID http://orcid.org/0000-0002-3223-670X
Andrea VergaraMicrobiology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Ana Martinez-UrreaInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Carolina Garcia-VidalInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Marta UlldemolinsInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Josep MensaInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Álex SorianoInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Marta BodroInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. mbodro@clinic.cat.

Funding

Hospital Clinic of Barcelona Emili Letang - Josep Font 2024Instituto de Salud Carlos III FIS PI24/01776
6 · The paper itself

Abstract

introductionCryptococcosis is a severe invasive fungal infection with limited therapeutic options beyond fluconazole-based regimens. Isavuconazole, a broad-spectrum triazole antifungal, has emerged as a potential alternative, although clinical data supporting its use remain scarce. We aimed to evaluate the real-world effectiveness and safety of isavuconazole in patients with different forms of cryptococcosis.

methodsA retrospective observational study was conducted at a tertiary-care hospital, including patients with cryptococcosis who received isavuconazole at any treatment phase. Standard microbiological methods were used for pathogen identification and susceptibility testing. Demographic, clinical, and microbiological data were collected. Clinical and microbiological responses and tolerability were assessed at end of treatment or until death.

resultEight patients with cryptococcosis received isavuconazole, most of whom were immunocompromised. Clinical presentations included pulmonary and disseminated disease, with Cryptococcus neoformans as the predominant species. Isavuconazole was primarily used during the consolidation and maintenance phases, after induction therapy with amphotericin B and flucytosine for 2 weeks in most cases, and as salvage therapy in two patients. It was well tolerated during prolonged treatment (6-12 months). In the two patients with isavuconazole therapeutic drug monitoring, plasma total trough concentrations were within the therapeutic range (5 and 3.5 µg/mL, respectively), whereas cerebrospinal fluid total concentration levels were undetectable. A favorable clinical response was observed in four patients, while three remain on treatment with ongoing clinical improvement; one patient died early. Microbiological clearance was achieved in all culture-positive cases.

conclusionsIsavuconazole demonstrated clinical effectiveness in this cohort of patients across different presentations of cryptococcosis. Treatment was safe and well tolerated, supporting its role as an alternative antifungal option against Cryptococcus, particularly when fluconazole is limited by adverse effects or drug-drug interactions. However, data on central nervous system penetration were limited, and further studies are needed to better define its role in cryptococcal meningitis management.

Indexed as

CryptococcosisFluconazoleImmunocompromisedIsavuconazoleMeningitis

Identifiers

PMID42332231
PMCPMC13476187

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