Isavuconazole in the Treatment of Coccidioidal Meningitis

Arash Heidari; Miriam Quinlan; David J Benjamin; Brett Laurence; Anandit Mu; Tiffany Ngai; Wes J Hoffman; Stuart H Cohen; Ian McHardy; Royce Johnson; George R Thompson 3rd

doi:10.1128/AAC.02232-18

Isavuconazole in the Treatment of Coccidioidal Meningitis

Antimicrob Agents Chemother. 2019 Feb 26;63(3):e02232-18. doi: 10.1128/AAC.02232-18. Print 2019 Mar.

Authors

Arash Heidari^{1

2}, Miriam Quinlan¹, David J Benjamin³, Brett Laurence⁴, Anandit Mu⁵, Tiffany Ngai⁵, Wes J Hoffman⁶, Stuart H Cohen⁷, Ian McHardy⁸, Royce Johnson^{1

2}, George R Thompson 3rd^{9

8}

Affiliations

¹ Kern County Medical Center, Bakersfield, California, USA.
² Valley Fever Institute, Bakersfield, California, USA.
³ Department of Internal Medicine, University of California Davis Medical Center, Sacramento, California, USA.
⁴ Sutter Medical Center, Sacramento, California, USA.
⁵ Department of Internal Medicine, Division of Infectious Diseases, University of California San Francisco-Fresno, Fresno, California, USA.
⁶ Department of Pharmacy, University of California Davis Medical Center, Sacramento, California, USA.
⁷ Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, California, USA.
⁸ Department of Medical Microbiology and Immunology, University of California Davis, Davis, California, USA.
⁹ Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, California, USA grthompson@ucdavis.edu.

Abstract

Patients with coccidioidal meningitis require lifelong antifungal therapy. Cumulative toxicity and lack of antifungal efficacy require salvage therapy in the treatment of some patients. In a retrospective review of nine patients with coccidioidal meningitis treated with isavuconazole, successful therapy was seen in three patients and stable disease was confirmed in six patients. Isavuconazole may be a useful addition to the therapeutic choices currently available for coccidioidal meningitis.

Keywords: coccidioides; isavuconazole; meningitis.

MeSH terms

Adult
Antifungal Agents / adverse effects
Antifungal Agents / therapeutic use*
Coccidioidomycosis / drug therapy*
Female
Humans
Male
Meningitis, Fungal / drug therapy*
Middle Aged
Nitriles / adverse effects
Nitriles / therapeutic use*
Pyridines / adverse effects
Pyridines / therapeutic use*
Retrospective Studies
Treatment Outcome
Triazoles / adverse effects
Triazoles / therapeutic use*

Substances

Antifungal Agents
Nitriles
Pyridines
Triazoles
isavuconazole