Real-World Use of Rezafungin for the Treatment of Challenging Aspergillus Infections.
7 affiliations
- 1Hospital for Tropical Diseases/University College London Hospitals Infection Division, London, UK.
- 2University Hospital Río Hortega, Valladolid, Spain.
- 3Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
- 4Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
- 5Infectious Diseases Unit, A Coruña University Hospital/Clinic Virology Group, Biomedical Research Institute of A Coruña, A Coruña, Spain.
- 6Infectious Diseases Department, Hospital Clínic de Barcelona-IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
- 7Infectious Diseases Unit, Puerta de Hierro-Majadahonda University Hospital, IDIPHISA, Madrid, Spain.
Abstract
Background
Aspergillus infections can pose significant treatment challenges, due in part to increasing triazole resistance. Clinical insight is needed to understand the potential for rezafungin, a next-generation echinocandin with once-weekly dosing, to address some limitations of current treatments for Aspergillus infections.Methods
This retrospective case series collected anonymized real-world data from eight adults who received once-weekly rezafungin for difficult-to-treat Aspergillus infections. The cases were provided by clinicians in Spain, the UK, and Italy with considerable experience in treating challenging fungal infections.Results
Most patients had pulmonary aspergillosis, nearly all had failed or were intolerant to triazole-based regimens, and half had prior echinocandin or amphotericin B exposure. Rezafungin was used primarily to enable outpatient parenteral antimicrobial therapy (OPAT), avoiding the need for daily IV echinocandin in settings of azole resistance or intolerance. About half received rezafungin as monotherapy; others had combination regimens. Clinical and/or radiological improvement or disease stabilization was observed in most cases, including in patients with azole-resistant infections. Notably, one patient achieved resolution of chronic otitis media, and others had negative cultures or sustained clinical benefit. Rezafungin was well tolerated, including in patients with renal impairment. One patient with chronic aspergilloma did not achieve adequate symptomatic control with rezafungin and required surgery.Conclusions
This report provides initial clinical insights on rezafungin as a potential option for difficult-to-treat Aspergillus infections. In this limited group of patients, rezafungin enabled OPAT, facilitated hospital discharge, and provided clinically meaningful improvements, including prolonged disease stabilization and resolution, which merit further investigation in clinical trials.
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BibTeX
@article{stone2026realworld,
title = {{Real-World Use of Rezafungin for the Treatment of Challenging Aspergillus Infections.}},
author = {Neil Stone and Pablo Bachiller-Luque and Simone Giuliano and Sumita Pai and Berta Pernas and Carolina Garcia-Vidal and Netta Tyler and Sara Ferin and Carlo Tascini and Ana Fernández Cruz},
journal = {Mycoses},
year = {2026},
month = oct,
doi = {10.1111/myc.70230},
url = {https://europepmc.org/article/MED/42952321},
note = {CC BY},
}
RIS
TY - JOUR
TI - Real-World Use of Rezafungin for the Treatment of Challenging Aspergillus Infections.
AU - Neil Stone
AU - Pablo Bachiller-Luque
AU - Simone Giuliano
AU - Sumita Pai
AU - Berta Pernas
AU - Carolina Garcia-Vidal
AU - Netta Tyler
AU - Sara Ferin
AU - Carlo Tascini
AU - Ana Fernández Cruz
PY - 2026
DA - 2026/10/29
JO - Mycoses
DO - 10.1111/myc.70230
UR - https://europepmc.org/article/MED/42952321
AB - Background Aspergillus infections can pose significant treatment challenges, due in part to increasing triazole resistance. Clinical insight is needed to understand the potential for rezafungin, a next-generation echinocandin with once-weekly dosing, to address some limitations of current treatments for Aspergillus infections.Methods This retrospective case series collected anonymized real-world data from eight adults who received once-weekly rezafungin for difficult-to-treat Aspergillus infections. The cases were provided by clinicians in Spain, the UK, and Italy with considerable experience in treating challenging fungal infections.Results Most patients had pulmonary aspergillosis, nearly all had failed or were intolerant to triazole-based regimens, and half had prior echinocandin or amphotericin B exposure. Rezafungin was used primarily to enable outpatient parenteral antimicrobial therapy (OPAT), avoiding the need for daily IV echinocandin in settings of azole resistance or intolerance. About half received rezafungin as monotherapy; others had combination regimens. Clinical and/or radiological improvement or disease stabilization was observed in most cases, including in patients with azole-resistant infections. Notably, one patient achieved resolution of chronic otitis media, and others had negative cultures or sustained clinical benefit. Rezafungin was well tolerated, including in patients with renal impairment. One patient with chronic aspergilloma did not achieve adequate symptomatic control with rezafungin and required surgery.Conclusions This report provides initial clinical insights on rezafungin as a potential option for difficult-to-treat Aspergillus infections. In this limited group of patients, rezafungin enabled OPAT, facilitated hospital discharge, and provided clinically meaningful improvements, including prolonged disease stabilization and resolution, which merit further investigation in clinical trials.
SN - 0933-7407
SN - 1439-0507
ER -