GREENBERG RN, ANSTEAD G, HERBRECHT R, LANGSTON A, MARR K, MULLANE K, RAAD I, SCHILLER G, SCHUSTER M, VAN BURIK J, WINGARD JR, HARE R, CORCORAN G; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. M-1757.

Univ. of Kentucky, Lexington, KY.

BACKGROUND: Zygomycosis is associated with significant morbidity and mortality in diabetic and other immunocompromised patients. Although treatment has historically been limited to amphotericin formulations, POS, a new triazole, has promising in vitro activity. METHODS: We evaluated clinical responses of POS in patients with proven or probable primary zygomycosis that were refractory to, or intolerant of, standard therapies. The patients in these open label studies were treated with oral POS 800 mg/day (200 mg QID or 400 mg BID) with an assessment of outcome from the investigator. For those patients still on therapy, the latest outcome was provided. Complete and partial responses were considered successful. RESULTS: Twenty-three patients were included in the analysis. Infections were caused by Rhizopus (9), Cunninghamella (5), Mucor (3), Rhizomucor (2) and unspecified Zygomycete (4). Patients had hematological malignancies (14), many with subsequent stem cell transplants (11), solid organ transplants (4), or diabetes (3). Successful outcomes were observed in 70% (16/23). Patients were treated for a mean of 137 days (range 6-352). For two patients, POS was given with another antifungal, one with caspofungin and the other with amphotericin B. Four of the nine deaths occurred in the first 30 days. The drug was well tolerated in treatment courses up to 352 days. CONCLUSIONS: POS is well tolerated and appears to have promising activity for zygomycosis that is refractory to other therapies. Future studies to evaluate efficacy for primary therapy may be appropriate.

Publication Types:

• Meeting Abstracts

Keywords:

• Amphotericin B
• Antifungal Agents
• Drug Therapy, Combination
• Humans
• In Vitro
• Peptides, Cyclic
• Rhizomucor
• Rhizopus
• Triazoles
• Zygomycosis
• Zygomycota
• caspofungin
• drug therapy
• posaconazole
• therapy

Other ID:

• GWAIDS0025234

UI: 102264858

From Meeting Abstracts