Invasive aspergillosis and the ICU

Prescribing information is available at the bottom of this page.

Invasive aspergillosis is a serious opportunistic infection associated with extremely high mortality.2 It typically affects individuals who are severely immunocompromised and/or have well-established risk factors, which may be related to:3–6

Overall, the majority of patients that contract the infection have a haematological malignancy as an underlying condition (>50% of cases).7 Looking specifically at the ICU patient population, however, information about the epidemiology of invasive aspergillosis is scarce, but data are emerging for this particular and unique setting.5

Underlying conditions in ICU patients with invasive aspergillosis (n=297)5

Unusual suspects

In addition to immunocompromised patients, it has become clear in recent years that Aspergillus species can cause invasive disease in less traditional categories of hosts for whom clinical risk factors are less defined, including critically ill patients admitted to the ICU.3–5,8 These patients may be mildly immunocompromised due to non-malignant conditions,9 or even have no immunosuppression or underlying diseases at all.4 As such, they may fall outside the standard EORTC/MSG definitions for invasive fungal disease,10 making the diagnosis of invasive aspergillosis a real challenge.In particular, invasive aspergillosis is a common complication of severe influenza in the ICU, affecting ~20% of patients.11,12

How many critically ill patients develop invasive aspergillosis in the ICU?a

a. Cases of invasive aspergillosis (mainly pulmonary) reported among ICU patients in different retrospective studies.

Consider CRESEMBA® for the treatment of invasive aspergillosis and mucormycosis. For further information, contact your Pfizer representative here.

Abbreviations: ARDS, acute respiratory distress syndrome; BMT, bone marrow transplant; COPD, chronic obstructive pulmonary disease; EORTC/MSG, European Organization for Research and Treatment of Cancer/Mycosis Study Group; HIV, human immunodeficiency virus; ICU, intensive care unit; TNF, tumour necrosis factor.
References
1. CRESEMBA Summary of Product Characteristics. 2. Lin SJ et al. Clin Infect Dis 2001;32(3):358–366. 3.  Bassetti M et al. Infect Dis Ther 2018;7(1):17–27. ECDC. Influenza-associated invasive pulmonary. 4. aspergillosis, Europe. 2018. Available from: https://www.ecdc.europa.eu/sites/portal/files/documents/aspergillus-and-.... Accessed July 2019. 5. Taccone FS et al. Crit Care 2015;19:7. 6. Baddley JW. Med Mycol 2011;49 Suppl 1:S7–S12. 7. Cornillet A et al. Clin Infect Dis 2006;43(5):577–584. 8. Bassetti M et al. IDCases 2018;12:7–9. 9. Delsuc C et al. Crit Care 2015;19:421. 10.  De Pauw B et al. Clin Infect Dis 2008;46(12):1813–1821. 11. Schauwvlieghe A et al. Lancet Respir Med. 2018;6(10):782–792. 12. Wauters J et al. Intensive Care Med 2012;38(11):1761–1768. 13. Gustot T et al. J Hepatol 2014;60(2):267–274. 14. Contou D et al. Ann Intensive Care 2016;6(1):52. 15. Levesque E et al. Ann Intensive Care 2019;9(1):31.

Prescribing Information 
This includes legal category, basic NHS cost and a link to SPC. Please click each relevant SPC link to be directed to EMC website.

Cresemba▼
Cresemba 100mg hard capsules – SPC
Legal Category: POM. Basic NHS Cost:14 caps pack £599.28
Cresemba 200mg powder for concentrate for solution for infusion – SPC
Legal Category: POM Basic NHS Cost: 1 vial pack £297.84

PP-CRB-GBR-0581. April 2020