%0 Journal Article %1 Singh2006b %A Singh, Nina %A Limaye, Ajit P. %A Forrest, Graeme %A Safdar, Nasia %A Muñoz, Patricia %A Pursell, Kenneth %A Houston, Sally %A Rosso, Fernando %A Montoya, Jose G. %A Patton, Pamela %A Del Busto, Ramon %A Aguado, Jose M. %A Fisher, Robert A. %A Klintmalm, Goran B. %A Miller, Rachel %A Wagener, Marilyn M. %A Lewis, Russell E. %A Kontoyiannis, Dimitrios P. %A Husain, Shahid %D 2006 %J Transplantation %K fungal drugs dosing pneumonia transplantation %N 3 %P 320--326 %R 10.1097/01.tp.0000202421.94822.f7 %T Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. %U http://dx.doi.org/10.1097/01.tp.0000202421.94822.f7 %V 81 %X : The efficacy of the combination of voriconazole and caspofungin when used as primary therapy for invasive aspergillosis in organ transplant recipients has not been defined.: Transplant recipients who received voriconazole and caspofungin (n=40) as primary therapy for invasive aspergillosis (proven or probable) in a prospective multicenter study between 2003 and 2005 were compared to a control group comprising a cohort of consecutive transplant recipients between 1999 and 2002 who had received a lipid formulation of AmB as primary therapy (n=47). In vitro antifungal testing of Aspergillus isolates to combination therapy was correlated with clinical outcome.: Survival at 90 days was 67.5\% (27/40) in the cases, and 51\% (24/47) in the control group (HR 0.58, 95\% CI, 0.30-1.14, P=0.117). However, in transplant recipients with renal failure (adjusted HR 0.32, 95\% CI: 0.12-0.85, P=0.022), and in those with A. fumigatus infection (adjusted HR 0.37, 95\% CI: 0.16-0.84, P=0.019), combination therapy was independently associated with an improved 90-day survival in multivariate analysis. No correlation was found between in vitro antifungal interactions of the Aspergillus isolates to the combination of voriconazole and caspofungin and clinical outcome.: Combination of voriconazole and caspofungin might be considered preferable therapy for subsets of organ transplant recipients with invasive aspergillosis, such as those with renal failure or A. fumigatus infection.

@article{Singh2006b, abstract = {: The efficacy of the combination of voriconazole and caspofungin when used as primary therapy for invasive aspergillosis in organ transplant recipients has not been defined.: Transplant recipients who received voriconazole and caspofungin (n=40) as primary therapy for invasive aspergillosis (proven or probable) in a prospective multicenter study between 2003 and 2005 were compared to a control group comprising a cohort of consecutive transplant recipients between 1999 and 2002 who had received a lipid formulation of AmB as primary therapy (n=47). In vitro antifungal testing of Aspergillus isolates to combination therapy was correlated with clinical outcome.: Survival at 90 days was 67.5\% (27/40) in the cases, and 51\% (24/47) in the control group (HR 0.58, 95\% CI, 0.30-1.14, P=0.117). However, in transplant recipients with renal failure (adjusted HR 0.32, 95\% CI: 0.12-0.85, P=0.022), and in those with A. fumigatus infection (adjusted HR 0.37, 95\% CI: 0.16-0.84, P=0.019), combination therapy was independently associated with an improved 90-day survival in multivariate analysis. No correlation was found between in vitro antifungal interactions of the Aspergillus isolates to the combination of voriconazole and caspofungin and clinical outcome.: Combination of voriconazole and caspofungin might be considered preferable therapy for subsets of organ transplant recipients with invasive aspergillosis, such as those with renal failure or A. fumigatus infection.}, added-at = {2013-03-30T03:26:06.000+0100}, author = {Singh, Nina and Limaye, Ajit P. and Forrest, Graeme and Safdar, Nasia and Muñoz, Patricia and Pursell, Kenneth and Houston, Sally and Rosso, Fernando and Montoya, Jose G. and Patton, Pamela and {Del Busto}, Ramon and Aguado, Jose M. and Fisher, Robert A. and Klintmalm, Goran B. and Miller, Rachel and Wagener, Marilyn M. and Lewis, Russell E. and Kontoyiannis, Dimitrios P. and Husain, Shahid}, biburl = {https://www.bibsonomy.org/bibtex/2e9887e536777873885b98f30a52cfad2/aorchid}, description = {see page 93 of notebook 00002. Overall no benefit, though trended that way. Only in subgroups of fumigatus or acute renal failure.}, doi = {10.1097/01.tp.0000202421.94822.f7}, file = {:ID_General/Fungus_most/Transplantation.81.320.pdf:PDF}, groups = {public}, institution = {Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15240, USA. nis5@pitt.edu}, interhash = {b9d24d34e6aa92078a342abbdf8bd26e}, intrahash = {e9887e536777873885b98f30a52cfad2}, journal = {Transplantation}, keywords = {fungal drugs dosing pneumonia transplantation}, language = {eng}, medline-pst = {ppublish}, month = Feb, number = 3, pages = {320--326}, pii = {00007890-200602150-00005}, pmid = {16477215}, timestamp = {2013-03-30T03:27:13.000+0100}, title = {Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study.}, url = {http://dx.doi.org/10.1097/01.tp.0000202421.94822.f7}, username = {aorchid}, volume = 81, year = 2006 }