title: Administration of Voriconazole in Disseminated Talaromyces (Penicillium) Marneffei Infection: A Retrospective Study.
abstract: Talaromyces (Penicillium) marneffei infection is a fatal disseminated mycosis caused by the dimorphic fungus Talaromyces marneffei; the therapeutic strategies for this infectious disease are limited. The aim of this retrospective study was to evaluate the efficacy and safety of voriconazole for treating patients with disseminated T. marneffei infection with or without HIV infection in a clinical setting. Patients who intravenously received voriconazole (6 mg/kg q12 h for the first 24 h followed by 4 mg/kg q12 h) as the initial antifungal treatment were enrolled. The duration of the following antifungal treatment varied at the discretion of the investigators according to the patient responses. The primary global response was evaluated at Week 16 or at the end of treatment (EOT). Follow-up evaluations were performed at 6 months and 1 year after the EOT. Seventeen patients were enrolled in this study, but three were not evaluable because the treatment was prematurely discontinued. Among the remaining fourteen patients, ten patients had complete response and three had partial response at Week 16. Only one patient was determined to have failed response. Follow-up assessments in eleven patients showed that eight patients were cured and the remaining three patients relapsed at 6 months after the EOT. These eight patients were assessed 1 year later, and none of them had relapsed. No adverse events associated with voriconazole were recorded during the treatment. The results from our study suggest that voriconazole is an effective, well-tolerated therapeutic option for disseminated T. marneffei infection.
authors.affiliation: Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
authors.forename: Yanyin
authors.initials: Y
authors.lastname: Ouyang
authors.affiliation: Department of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
authors.forename: Shuangqi
authors.initials: S
authors.lastname: Cai
authors.affiliation: Center for AIDS Research & School of Public Health, Guangxi Medical University, Nanning, 530021, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China. caocunwei@yeah.net.
authors.forename: Cunwei
authors.initials: C
authors.lastname: Cao
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D016469:Fungemia / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D032901:Talaromyces / Q000302:isolation & purification*; D016896:Treatment Outcome; D065819:Voriconazole / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D065819:Voriconazole
keywords: Disseminated Talaromyces marneffei infection; Efficacy; Safety; Voriconazole