Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 6;7(5):dlaf177.
doi: 10.1093/jacamr/dlaf177. eCollection 2025 Oct.

Use of isavuconazole in critically ill patients in intensive care units: a prospective, observational, multicentre, cohort study

Daniele Roberto Giacobbe  1   2 , Claudia Bartalucci  1 , Martina Bavastro  1   2 , Riccardo Schiavoni  1   2 , Vincenzo Di Pilato  3   4 , Marco Muccio  2 , Alessio Signori  5 , Chiara Aldieri  6 , Jacopo Angelini  7   8 , Erika Asperges  9   10 , Elisabetta Blasi Vacca  11 , Nicoletta Boffa  12 , Enrica Bono  10 , Bruno Cacopardo  13 , Alessandra Calabresi  14 , Martina Casarini  15 , Annamaria Cattelan  16 , Silvia Corcione  17   18 , Federica Cosentino  13 , Gennaro De Pascale  19   20 , Francesco Giuseppe De Rosa  17 , Valerio Del Bono  6 , Filippo Del Puente  11 , Chiara Fanelli  21 , Fiorenza Fava  22 , Erica Franceschini  23 , Nicholas Geremia  24   25 , Maddalena Giannella  15   26 , Simone Giuliano  27 , Ivana Maida  21 , Andrea Marino  13 , Maria Mazzitelli  16   28   29 , Maria Chiara Meloni  21 , Marco Merli  30 , Marianna Meschiari  23 , Chiara Moreal  7 , Chiara Oltolini  30 , Rita Pallone  31   32 , Sandro Panese  24   25 , Emanuele Pontali  11 , Martina Ricciardetto  23 , Matteo Rinaldi  15   26 , Alessandro Russo  31   32 , Maurizio Sanguinetti  19   33 , Vincenzo Scaglione  16 , Francesca Serapide  31   32 , Francesco Saverio Serino  34 , Nour Shbaklo  17 , Carlo Torti  28   29 , Giovanna Travi  30 , Laura Magnasco  2 , Federica Portunato  2 , Federica Briano  2 , Malgorzata Mikulska  1   2 , Lorenzo Ball  3   35 , Chiara Robba  3   35 , Nicolò Patroniti  3   35 , Denise Battaglini  3   35 , Mauro Giacomini  36 , Erika Coppo  4 , Anna Marchese  3   4 , Antonio Vena  1   2 , Matteo Bassetti  1   2 ; ISA-SITA investigators
Collaborators, Affiliations

Use of isavuconazole in critically ill patients in intensive care units: a prospective, observational, multicentre, cohort study

Daniele Roberto Giacobbe et al. JAC Antimicrob Resist. .

Abstract

Objectives: In this multicentre, prospective study, we aimed to describe the use of isavuconazole in critically ill adult patients in ICU, in terms of patient characteristics, infection characteristics and outcomes.

Methods: Prospective, observational study of ICU patients treated with isavuconazole from January 2023 to 30 April 2025 in 17 centres (ISA-SITA study within the MULTI-SITA project).

Results: A total of 177 ICU patients treated with isavuconazole were included in the study. Most patients showed at least one European Organisation for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) or FUNgal Diseases in adult patients in Intensive Care Unit (FUNDICU) host factor (141/177, 79.7%). Overall, 82/177 patients (46.3%) had either proven or probable invasive mould disease (6 and 76, respectively, mostly invasive pulmonary aspergillosis). In patients with proven or probable disease, 30-day mortality was 44.0%, and 90-day mortality was 62.2%. In multivariable analyses, SOFA score (HR 1.14 per one point increase, 95% CI 1.03-1.26, P = 0.010) and concomitant bacterial pneumonia (HR 2.32, 95% CI 1.17-4.59, P = 0.016) were associated with 30-day mortality, whereas prior hospitalization (HR 2.26, 95% CI 1.19-4.27, P = 0.013) and SOFA score (HR 1.17 per one point increase, 95% CI 1.07-1.28, P < 0.001) were associated with 90-day mortality.

Conclusions: Diverse patterns of isavuconazole use were observed in a large cohort of critically ill adult patients, and the drug was well tolerated. Mortality was lower than many previous estimates in critically ill patients and could serve as a basis for future standardized comparisons.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative mortality up to Day 30 in critically ill patients with proven and probable invasive aspergillosis/mucormycosis treated with isavuconazole. (a) Cumulative mortality up to Day 30 in ICU patients with proven or probable invasive mould disease treated with isavuconazole. (b) Cumulative mortality up to Day 30 in ICU patients with probable invasive mould disease treated with isavuconazole, stratified for classification as probable according to EORTC/MSGERC versus FUNDICU definitions. For both panels, the time of origin was set at the day of isavuconazole initiation. Death was the event of interest and right-censoring was applied at the end of follow-up (loss to follow-up before Day 30, e.g. for hospital discharge, or Day 30, whichever came first). For further details, see Materials and methods. EORTC, European Organisation for Research and Treatment of Cancer; FUNDICU, invasive FUNgal Diseases in adult patients in Intensive Care Unit; MSGERC, Mycoses Study Group Education and Research Consortium.
See this image and copyright information in PMC

References

    1. Ellsworth M, Ostrosky-Zeichner L. Isavuconazole: mechanism of action, clinical efficacy, and resistance. J Fungi (Basel) 2020; 6: 324. 10.3390/jof6040324 - DOI - PMC - PubMed
    1. Maertens JA, Raad II, Marr KA et al. Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial. Lancet 2016; 387: 760–9. 10.1016/S0140-6736(15)01159-9 - DOI - PubMed
    1. Marty FM, Ostrosky-Zeichner L, Cornely OA et al. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis 2016; 16: 828–37. 10.1016/S1473-3099(16)00071-2 - DOI - PubMed
    1. Sivasubramanian G, Chandrasekar PH. Efficacy and safety of Isavuconazole for the treatment of invasive Aspergillus infection—an update of the literature. Expert Opin Pharmacother 2022; 23: 543–9. 10.1080/14656566.2022.2032645 - DOI - PubMed
    1. Cornely OA, Alastruey-Izquierdo A, Arenz D et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis 2019; 19: e405–21. 10.1016/S1473-3099(19)30312-3 - DOI - PMC - PubMed

LinkOut - more resources