
Isavuconazonium Sulfate Capsules (Cresemba) is a broad-spectrum triazole antifungal drug, with isavuconazole as its active ingredient. As a new type of antifungal agent, Cresemba demonstrates unique advantages in the treatment of invasive fungal infections.
How Effective is Isavuconazonium Sulfate Capsules (Cresemba) in Treatment?
Antifungal Spectrum
Cresemba exerts its antifungal effect by inhibiting the synthesis of ergosterol in the fungal cell membrane, thereby disrupting the integrity of the membrane structure.
Invasive Aspergillosis: It is effective against common pathogenic fungi such as Aspergillus fumigatus, Aspergillus flavus, and Aspergillus niger.
Mucormycosis (Zygomycosis): It is effective against fungi like Rhizopus oryzae and Mucor species. Especially when the efficacy of traditional antifungal drugs is limited, it can serve as an important treatment option.
Characteristics of Clinical Efficacy
Rapid Onset of Action: Through loading dose administration (within the first 48 hours), effective blood drug concentration is quickly achieved.
Flexible Dosage Forms: It supports sequential therapy via intravenous injection and oral administration, with high bioavailability, making it convenient for outpatient or home-based treatment.
Target Population for Isavuconazonium Sulfate Capsules (Cresemba)
Core Indications
Invasive Aspergillosis: Particularly suitable for cases of pulmonary infection and disseminated infection.
Invasive Mucormycosis: Serves as a first-line or salvage treatment option for severe infections such as rhino-cerebral and pulmonary mucormycosis.
Considerations for Special Populations
Immunocompromised Patients: For example, patients with hematological malignancies or those who develop fungal infections after hematopoietic stem cell transplantation.
Patients with Comorbid Underlying Diseases: Hepatic and renal functions should be evaluated. Patients with mild to moderate liver impairment do not require dosage adjustment, while those with severe liver impairment should use the drug with caution.
Contraindicated Populations: Contraindicated in patients allergic to isavuconazole, patients with familial short QT syndrome, and those receiving concurrent administration of strong CYP3A4 inhibitors/inducers (e.g., ketoconazole, rifampicin).
Key Points for Medication Monitoring of Isavuconazonium Sulfate Capsules (Cresemba)
Pre-Treatment Assessment
Etiological Confirmation: Whenever possible, the pathogen should be identified through histopathology or culture to guide targeted treatment.
Baseline Liver Function Tests: Indicators such as ALT, AST, and bilirubin should be tested, especially for patients with a history of liver disease.
Drug Interactions
For immunosuppressants (e.g., tacrolimus, cyclosporine), blood drug concentrations should be monitored and dosages adjusted accordingly.
Dosage reduction may be necessary for P-gp substrate drugs (e.g., digoxin).