{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:48:06Z","timestamp":1779216486016,"version":"3.51.4"},"reference-count":112,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T00:00:00Z","timestamp":1646438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Aspergillus fracture-related infection (FRI) is a rare, but severe complication in trauma surgery. The optimal antifungal treatment for Aspergillus osteomyelitis, including FRI, has not been established yet, as only cases have been documented and data on bone penetration of antifungal drugs are scarce. We describe a patient with Aspergillus fumigatus FRI of the tibia who was treated with isavuconazole after developing liver function disturbances during voriconazole therapy. Isavuconazole, the active moiety formed after hydrolysis of the prodrug isavuconazonium sulfate by plasma esterases, was administered in a maintenance dose of 200 mg q24 h, followed by 150 mg q24 h. The patient completed a six-month antifungal treatment course. Although fracture union was not achieved during six months of follow-up after therapy cessation, no confirmatory signs of FRI were observed. Additionally, two literature searches were conducted to review available data on antifungal treatment of Aspergillus osteomyelitis and bone penetration of antifungals. One hundred and eight cases of Aspergillus osteomyelitis, including six (5.6%) FRI cases, were identified. Voriconazole and (lipid formulations of) amphotericin B were the most commonly used antifungals. In three (2.8%) cases isavuconazole was prescribed as salvage therapy. Data on antifungal bone penetration were reported for itraconazole, voriconazole, amphotericin B, anidulafungin and 5-fluorocytosin. Isavuconazole might be a promising alternative for the treatment of Aspergillus osteomyelitis. However, standardized case documentation is needed to evaluate the efficacy of isavuconazole and other antifungals in the treatment of Aspergillus osteomyelitis, including FRI.<\/jats:p>","DOI":"10.3390\/antibiotics11030344","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:35:50Z","timestamp":1646598950000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Isavuconazole in the Treatment of Aspergillus fumigatus Fracture-Related Infection: Case Report and Literature Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-3045","authenticated-orcid":false,"given":"Beatrijs","family":"Mertens","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Pharmacy Department, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8353-2103","authenticated-orcid":false,"given":"Ruth","family":"Van Daele","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Pharmacy Department, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Depypere","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8668-1350","authenticated-orcid":false,"given":"Katrien","family":"Lagrou","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine, University Hospitals Leuven, B-3000 Leuven, Belgium"},{"name":"Belgian National Reference Center for Mycosis, University Hospitals Leuven, B-3000 Leuven, Belgium"},{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Debaveye","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Medicine, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Intensive Care Unit, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost","family":"Wauters","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine, University Hospitals Leuven, B-3000 Leuven, Belgium"},{"name":"Medical Intensive Care Unit, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefaan","family":"Nijs","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Department of Trauma Surgery, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4114-9093","authenticated-orcid":false,"given":"Willem-Jan","family":"Metsemakers","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Department of Trauma Surgery, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Spriet","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"Pharmacy Department, University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.cmi.2019.08.006","article-title":"Pathogenesis and management of fracture-related infection","volume":"26","author":"Depypere","year":"2019","journal-title":"Clin. 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