{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:08:58Z","timestamp":1793048938094,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Geriatrics, Hospital Monte Naranco Asturias"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Background: Invasive aspergillosis (IA) is a severe fungal infection increasingly affecting elderly patients with chronic respiratory diseases and prolonged corticosteroid use. Methods: 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. Results: Overall mortality was 35.61%. Significant mortality risk factors included leukocytosis (p = 0.0371), neutrophilia (p = 0.0144), and lymphopenia (p = 0.0274). Deceased patients had longer hospital stays (26.6 vs. 16.8 days; p = 0.00353). Voriconazole treatment was associated with higher 30-day mortality (61.5% vs. 19.2%; p = 0.0001) and a higher incidence of adverse effects (60% vs. 5%; p = 0.0003) compared to isavuconazole. Voriconazole also showed greater pharmacokinetic variability, with 76.9% of cases outside the therapeutic range. Conclusions: 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.<\/jats:p>","DOI":"10.3390\/jof11070480","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T03:53:02Z","timestamp":1750823582000},"page":"480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Current Challenges in the Treatment of Invasive Aspergillosis in Geriatric Patients"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5889-1749","authenticated-orcid":false,"given":"Sara","family":"Fueyo \u00c1lvarez","sequence":"first","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Valle","family":"Calonge","sequence":"additional","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"},{"name":"Instituto de Investigaciones Sanitarias del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieth Andrea","family":"Caballero Velasquez","sequence":"additional","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba Magaly","family":"Revelo Rueda","sequence":"additional","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0412-6578","authenticated-orcid":false,"given":"Pablo Enrique","family":"Solla Suarez","sequence":"additional","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"},{"name":"Instituto de Investigaciones Sanitarias del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-1591","authenticated-orcid":false,"given":"Eva Mar\u00eda","family":"L\u00f3pez \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Hospital Monte Naranco, 33012 Oviedo, Spain"},{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"},{"name":"Instituto de Investigaciones Sanitarias del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4378-3266","authenticated-orcid":false,"given":"Mercedes","family":"Rodriguez Perez","sequence":"additional","affiliation":[{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"},{"name":"Instituto de Investigaciones Sanitarias del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Pel\u00e1ez Garc\u00eda de la Rasilla","sequence":"additional","affiliation":[{"name":"Hospital Central de Asturias, 33011 Oviedo, Spain"},{"name":"Instituto de Investigaciones Sanitarias del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e428","DOI":"10.1016\/S1473-3099(23)00692-8","article-title":"Global incidence and mortality of severe fungal disease","volume":"24","author":"Denning","year":"2024","journal-title":"Lancet Infect. 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