Age (years)
|
Comorbidities
|
Time
from LT
|
Fungal pathogen
|
Antifungal treatment indication
|
Treatment site
|
Justification for voriconazole nebulization initiation
|
Dosage
|
Voriconazole powder for solution for infusion brand
|
Other treatments
|
DOT
|
Outcome
|
35
|
CF
|
3 m
|
Scedosporium prolificans
|
Respiratory distress
|
Hospital ward
Outpatient treatment
|
Lack of response to oral voriconazole
|
40mg/24h
40mg/12h
|
Kern®
|
Voriconazole (oral)
|
122
|
Clinical, radiological an microbiological response
|
21
|
CF
|
NT
|
Aspergillus citrinoterreus
- Aspergillus terreus (R to amphotericin and voriconazole)
|
Fungal colonization
|
Hospital ward
Outpatient treatment
|
Symptomatic liver toxicity to systemic azoles
|
40mg /12h
40mg/24h
40mg 3/ w
|
Kern®
Normon®
|
Isavuconazole (oral)
|
>420
|
Resolved liver toxicity
Fungal colonization remains present
Nebulized voriconazole treatment continues and it is well tolerated
|
35
|
CF
|
0 d
|
Scedosporium prolificans (multi-drug R, S to voriconazole)
|
LT fungal prophylaxis after isolation of S. prolificans in the
graft preservation fluid
|
Hospital ward
Outpatient treatment
ICU
|
Need of topical antifungal prophylaxis after LT active against
Scedosporium prolificans R to amphotericin
|
40mg/12h
|
Kern®
|
Micafungin (neb)
|
>170
|
Successful LT
Nebulized voriconazole treatment continues and it is well tolerated
|
69
|
Nonspecific interstitial pneumonia
|
4 y
|
Aspergillus flavus (R to amphotericin)
|
Bronchitis
|
Hospital ward
Outpatient treatment
|
Lack of response to anidulafungin
Symptomatic toxicity to azoles (dizziness, myopathy).
|
40mg/12h
40mg/24h
|
Accord®
|
Isavuconazole (oral)
|
911
|
Aspergillus flavus is still present in bronchoalveolar lavage
After voriconazole treatment, Aspergillus flavus showed
resistance to this treatment and treatment was changed to nebulized
liposomal amphotericin
|
60
|
Idiopathic pulmonary fibrosis
|
1 m
|
Scedosporoium apiospermum complex
|
Colonization
|
Outpatient treatment
|
Combination of nebulized and systemic treatment to readily reach
therapeutic voriconazole concentration in the lung.
|
40mg/12h
|
Kern®
|
- Voriconazole (oral)
|
>156
|
Microbiological response
Oral treatment was stopped due to visual and liver toxicity
Nebulized voriconazole treatment continues and it is well tolerated
|
65
|
Chronic obstructive pulmonary disease
|
7 m
|
Aspergillus fumigatus
- Aspergillus flavus
|
Respiratory distress
|
Hospital ward
|
Avoiding clinically relevant drug-drug interaction among systemic
azoles and sirolimus
|
40mg/12h
|
Kern®
|
None
|
26
|
Patient died due to graft failure
|
64
|
Chronic obstructive pulmonary disease
|
NT
|
Purpureocilium lilacinus (multi-drug R; S to voriconazole,
posaconazole and isavuconazole)
|
Respiratory distress
|
Hospital ward
|
Symptomatic toxicity so systemic azoles
Kidney failure
Avoiding clinically relevant drug-drug interaction among systemic
azoles and sirolimus.
|
40mg/12h
|
Teva®
|
None
|
30
|
Patient died, P. lilacinus was not found in the last
bronchoalveolar lavage
|
18
|
CF
|
NT
|
Scedosporium apiospermum complex (multi-drug R, S to
voriconazole, posaconazole, isavuconazole and micafungin)
|
Colonization
|
Outpatient treatment
|
Symptomatic toxicity to systemic azoles (rash)
|
40mg/48h
40mg /24h
|
Teva®
Kern®
Normon®
|
Posaconazole (oral)
|
>840
|
Colonization remained
Nebulized voriconazole treatment continues and it is well tolerated
|
30
|
CF
|
7 y / 0 d*
|
Aspergillus flavus complex (R to amphotericin)
Aspergillus terreus complex (R to amphotericin)
|
Surgery complications after second LT
|
ICU
|
Lack of response to previous treatments
|
40mg/24h
|
Kern®
|
Isavuconazole (IV)
Micafungin (IV)
Liposomal amphoterin (IP)
|
28
|
Patient died due to IPA
|
5
|
Interstitial neumopathy
|
9 m
|
Aspergillus flavus complex (R to amphotericin)
|
Respiratory distress
|
P-ICU
|
Lack of response to previous treatments.
|
10mg/24h
|
Normon®
|
Liposomal amphotericin (neb)
Isavuconazole (IV)
Anidulafungin (IV)
|
81
|
Microbiological response
Nebulized voriconazole treatment continues and it is well tolerated
|