O04 Use of the novel antifungal rezafungin in outpatient parenteral antibiotic therapy: early experience from a single centre
Notice bibliographique
Résumé
Abstract Background Rezafungin is a novel long-acting echinocandin antifungal drug with weekly dosing, which was licensed for treatment of invasive candidiasis in the UK in January 2024. We report on the early use of rezafungin in our outpatient parental antibiotic therapy (OPAT) service. Objectives To review indications, treatment regimens, outcomes and adverse events in adult patients receiving rezafungin at a tertiary infectious disease centre. Methods All adult patients who received rezafungin therapy via the OPAT service since it was added to the hospital formulary in July 2024 were included. Patient demographics, infection diagnosis, treatment regimens and outcomes were recorded. A single dose of rezafungin was assumed to be equivalent to seven doses of a comparable echinocandin (e.g. anidulafungin). Results Five patients (age range 30–80 years) received rezafungin therapy between July 2024 and October 2024. A total of 18 doses were administered. The median course length was 4 doses (range: 2–5). One patient received two courses of rezafungin as part of a planned series, otherwise patients received a single course. Indications for treatment were Candida osteomyelitis, recurrent mucocutaneous candidiasis (3 oral/oesophageal, 2 resistant or refractory to fluconazole; 1 drug interactions), and pulmonary aspergilloma (cyclical use: 2 weeks’ course every 8 weeks, in combination with voriconazole due to progression on monotherapy). Reasons for choosing rezafungin over daily echinocandins were patient preference/convenience, facilitating earlier patient discharge (1 case) and cost effectiveness compared with the cost of daily caspofungin administration by the OPAT nurses. Underlying conditions predisposing to fungal infection were diabetes mellitus (3), immunosuppression secondary to liver transplantation, STAT1 gain-of-function mutation and multisystem sarcoidosis on long-term prednisolone. All patients with mucocutaneous candidiasis reported a treatment response; treatment in the patient with aspergilloma and the patient with osteomyelitis is ongoing. Regarding treatment-emergent adverse reactions: there were no cases of pyrexia, hypokalaemia, pneumonia or septic shock (the most common AEs in reported in the RESTORE trial). One hundred and nine doses of equivalent echinocandin were saved through once weekly dosing. Conclusions Early use of rezafungin at our centre suggests it is a well-tolerated, convenient and useful addition to the antifungal armamentarium, particularly in the outpatient setting. Monitoring of blood tests is essential, particularly haemoglobin, renal function and electrolytes, including magnesium.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».