# Isavuconazole as an optimal treatment option for multiple pathogens induced severe pneumonia in immunocompromised hosts: a case series report

## TL;DR

This case series explores the effectiveness of isavuconazole in treating severe pneumonia caused by multiple pathogens in immunocompromised patients.

## Contribution

The study provides clinical evidence for isavuconazole's efficacy in complex infections involving multiple pathogens in immunocompromised hosts.

## Key findings

- Isavuconazole-based treatment led to symptom alleviation and absorption of pulmonary lesions in all three patients.
- No significant hepatorenal toxicity or recurrence was observed in patients treated with isavuconazole.
- Isavuconazole showed robust efficacy in treating invasive aspergillosis with minimal adverse drug reactions.

## Abstract

Treating severe pneumonia caused by multiple pathogens in immunocompromised hosts (ICHs) presents significant challenges. Isavuconazole (ISA), a next-generation triazole antifungal agent, has shown promise in managing fungal infections. However, clinical evidence regarding its efficacy in cases of complex infections involving multiple pathogens in ICHs remains limited.

This study describes a case series of three ICHs diagnosed with severe pneumonia, including invasive aspergillosis (IA). All three patients received ISA-based personalized antimicrobial regimens. Alleviation of symptoms was observed in all patients following antimicrobial treatment, with notable absorption of pulmonary lesions and no significant hepatorenal toxic side effects, with no recurrence observed.

ICHs are highly susceptible to fungal infections, and the severity of their condition can escalate dramatically, with a significant risk of mortality, when severe pneumonia caused by multiple pathogens occurs concurrently. A stepwise treatment strategy, which balances the use between immunosuppressant and effective antimicrobial treatment, is crucial. The selection of appropriate drugs should account for potential adverse drug reactions (ADRs). In this case series, ISA exhibited robust efficacy in treating IA with minimal ADRs. Therefore, ISA represents a valuable option for managing severe pneumonia in ICHs, particularly in the context of IA and co-infections caused by multiple pathogens.