학술논문

New Perspectives on Antimicrobial Agents: Isavuconazole
Document Type
article
Source
Antimicrobial Agents and Chemotherapy. 66(9)
Subject
Emerging Infectious Diseases
Infectious Diseases
Antifungal Agents
Candidiasis
Invasive
Caspofungin
Fungi
Humans
Invasive Fungal Infections
Nitriles
Pyridines
Triazoles
Voriconazole
isavuconazole
isavuconazonium sulfate
spectrum
review
clinical data
drug-drug interactions
posaconazole
prophylaxis
treatment
voriconazole
Microbiology
Medical Microbiology
Pharmacology and Pharmaceutical Sciences
Language
Abstract
Isavuconazole is the newest of the clinically available advanced generation triazole antifungals and is active against a variety of yeasts, molds, and dimorphic fungi. Its current FDA-approved indications include the management of invasive aspergillosis as well as mucormycosis, though the latter indication is supported by limited clinical data. Isavuconazole did not achieve noninferiority to caspofungin for the treatment of invasive candidiasis and therefore lacks an FDA-approved indication for this invasive disease. Significant advantages of isavuconazole, primarily over voriconazole but in some circumstances posaconazole as well, make it an appealing option for the management of complex patients with invasive fungal infections. These potential advantages include lack of QTc interval prolongation, more predictable pharmacokinetics, a less complicated drug interaction profile, and improved tolerability, particularly when compared to voriconazole. This review discusses these topics in addition to addressing the in vitro activity of the compound against a variety of fungi and provides insight into other distinguishing factors among isavuconazole, voriconazole, and posaconazole. The review concludes with an opinion section in which the authors provide the reader with a framework for the current role of isavuconazole in the antifungal armamentarium and where further data are required.