Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients
<b>Background:</b> Invasive aspergillosis (IA) is a severe fungal infection increasingly affecting elderly patients with chronic respiratory diseases and prolonged corticosteroid use. <b>Methods:</b> We evaluated clinical, biochemical, and fungal biomarkers in 45 patients ove...
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MDPI AG
2025-06-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/11/7/480 |
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| author | Sara Fueyo Álvarez Elena Valle Calonge Julieth Andrea Caballero Velasquez Alba Magaly Revelo Rueda Pablo Enrique Solla Suarez Eva María López Álvarez Mercedes Rodriguez Perez María Teresa Peláez García de la Rasilla |
| author_facet | Sara Fueyo Álvarez Elena Valle Calonge Julieth Andrea Caballero Velasquez Alba Magaly Revelo Rueda Pablo Enrique Solla Suarez Eva María López Álvarez Mercedes Rodriguez Perez María Teresa Peláez García de la Rasilla |
| author_sort | Sara Fueyo Álvarez |
| collection | DOAJ |
| description | <b>Background:</b> Invasive aspergillosis (IA) is a severe fungal infection increasingly affecting elderly patients with chronic respiratory diseases and prolonged corticosteroid use. <b>Methods:</b> We evaluated clinical, biochemical, and fungal biomarkers in 45 patients over 80 years diagnosed with IA and hospitalized in a Spanish Acute Geriatric Unit. Patients received either voriconazole or isavuconazole. Mortality rates and associated risk factors were analyzed. <b>Results:</b> Overall mortality was 35.61%. Significant mortality risk factors included leukocytosis (<i>p</i> = 0.0371), neutrophilia (<i>p</i> = 0.0144), and lymphopenia (<i>p</i> = 0.0274). Deceased patients had longer hospital stays (26.6 vs. 16.8 days; <i>p</i> = 0.00353). Voriconazole treatment was associated with higher 30-day mortality (61.5% vs. 19.2%; <i>p</i> = 0.0001) and a higher incidence of adverse effects (60% vs. 5%; <i>p</i> = 0.0003) compared to isavuconazole. Voriconazole also showed greater pharmacokinetic variability, with 76.9% of cases outside the therapeutic range. <b>Conclusions:</b> Voriconazole may not be optimal for IA treatment in patients over 80 years. Isavuconazole demonstrated a more favorable safety and efficacy profile. Personalized therapeutic strategies and a multidisciplinary approach are essential to improve clinical outcomes and quality of life in this vulnerable population. |
| format | Article |
| id | doaj-art-b368925780564828bd7b28be2cf3ee56 |
| institution | Kabale University |
| issn | 2309-608X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj-art-b368925780564828bd7b28be2cf3ee562025-08-20T03:58:29ZengMDPI AGJournal of Fungi2309-608X2025-06-0111748010.3390/jof11070480Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric PatientsSara Fueyo Álvarez0Elena Valle Calonge1Julieth Andrea Caballero Velasquez2Alba Magaly Revelo Rueda3Pablo Enrique Solla Suarez4Eva María López Álvarez5Mercedes Rodriguez Perez6María Teresa Peláez García de la Rasilla7Hospital Monte Naranco, 33012 Oviedo, SpainHospital Monte Naranco, 33012 Oviedo, SpainHospital Monte Naranco, 33012 Oviedo, SpainHospital Monte Naranco, 33012 Oviedo, SpainHospital Monte Naranco, 33012 Oviedo, SpainHospital Monte Naranco, 33012 Oviedo, SpainHospital Central de Asturias, 33011 Oviedo, SpainHospital Central de Asturias, 33011 Oviedo, Spain<b>Background:</b> Invasive aspergillosis (IA) is a severe fungal infection increasingly affecting elderly patients with chronic respiratory diseases and prolonged corticosteroid use. <b>Methods:</b> We evaluated clinical, biochemical, and fungal biomarkers in 45 patients over 80 years diagnosed with IA and hospitalized in a Spanish Acute Geriatric Unit. Patients received either voriconazole or isavuconazole. Mortality rates and associated risk factors were analyzed. <b>Results:</b> Overall mortality was 35.61%. Significant mortality risk factors included leukocytosis (<i>p</i> = 0.0371), neutrophilia (<i>p</i> = 0.0144), and lymphopenia (<i>p</i> = 0.0274). Deceased patients had longer hospital stays (26.6 vs. 16.8 days; <i>p</i> = 0.00353). Voriconazole treatment was associated with higher 30-day mortality (61.5% vs. 19.2%; <i>p</i> = 0.0001) and a higher incidence of adverse effects (60% vs. 5%; <i>p</i> = 0.0003) compared to isavuconazole. Voriconazole also showed greater pharmacokinetic variability, with 76.9% of cases outside the therapeutic range. <b>Conclusions:</b> Voriconazole may not be optimal for IA treatment in patients over 80 years. Isavuconazole demonstrated a more favorable safety and efficacy profile. Personalized therapeutic strategies and a multidisciplinary approach are essential to improve clinical outcomes and quality of life in this vulnerable population.https://www.mdpi.com/2309-608X/11/7/480invasive aspergillosisgeriatricsmortality |
| spellingShingle | Sara Fueyo Álvarez Elena Valle Calonge Julieth Andrea Caballero Velasquez Alba Magaly Revelo Rueda Pablo Enrique Solla Suarez Eva María López Álvarez Mercedes Rodriguez Perez María Teresa Peláez García de la Rasilla Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients Journal of Fungi invasive aspergillosis geriatrics mortality |
| title | Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients |
| title_full | Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients |
| title_fullStr | Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients |
| title_full_unstemmed | Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients |
| title_short | Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients |
| title_sort | current challenges in the treatment of invasive aspergillosis in geriatric patients |
| topic | invasive aspergillosis geriatrics mortality |
| url | https://www.mdpi.com/2309-608X/11/7/480 |
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