Prescribing information is available at the bottom of this page.

A diagnostic approach to treating invasive fungal infections can aid in both early treatment of patients as well as improving the chances of survival2-5,7. Please see below for example of how to approach diagnostics.

A diagnostic-driven approach allows early treatment (in neutropenic patients with or without fever)2-5

A combination of diagnostic assessments is recommended:6

  • Monitoring of Galactomannan (GM) may be used in patients who have a relatively high probability (>5-10%) of developing invasive aspergillosis (IA)

  • Appropriate clinical and microbiological evaluation

  • High-resolution computed tomography (CT) imaging

CT Section of haematological lung malignancy

 

 

A diagnostic-driven approach has the potential to help you improve the patients' chance of survival7

  • Routine GM screening is shown to lead to the early initiation of antifungal therapy5
  • Initiating appropriate treatment on the basis of CT patterns has been shown to improve survival*7
  • Increased survival was observed in patients with pulmonary invasive aspergillosis who presented with a halo sign versus those with other imaging findings at week 12: 71% vs 53%, respectively (p<0.01)7
*Analysis of chest CT findings at presentation from a large series (n=235) of patients with invasive pulmonary aspergillosis (IPA), to assess the prevalence of a "halo sign" and to evaluate the clinical utility of this imaging finding for early identification and treatment of IPA.7
Cresemba
®(isavuconazole) is not indicated for the empirical treatment of invasive aspergillosis.

 

Example of a diagnostic-driven antifungal therapy integrated care pathway8

A diagnostic-driven antifungal care pathway

*Check response on day 7. If no response to treatment, further diagnosis is required; if patient responds to treatment, consider the duration of therapy, "step down" therapy, and outpatient follow up.

Multidisciplinary team input important at this stage.

IFD, invasive fungal disease; IMD, invasive mold disease; PCR, polymerase chain reaction

References

  1. CRESEMBA Summary of Product Characteristics.
  2. Rogers TR, et al. Br J Haematol. 2011; 153(6): 681–97.
  3. Freemantle N, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i25–35.
  4. de Pauw BE& Viscoli C. J Antimicrob Chemother. 2011; 66(Suppl 1): i55–8.
  5. Maertens J, et al. Clin Infect Dis. 2005; 41(9): 1242–50.
  6. Marchetti O et al. Bone Marrow Transplant. 2012; 47(6): 846–54.
  7. Greene RE, et al. Clin Infect Dis. 2007; 44(3): 373–9.
  8. Agrawal S, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i45-53.

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-0460.  August 2019