296 RASolve 301 Trial in Progress: A Phase 3 Study of Daraxonrasib (RMC-6236) vs. Docetaxel in Patients with Previously Treated RAS-Mutant Non-Small Cell Lung Cancer (NSCLC)

Lung Cancer · 2026-02-01

MUC16-dependent Renal Vascular Adhesion of Candida Promotes Tissue Invasion and Predicts Clinical Outcome in Candidemia

Research Square · 2026-03-04

Comprehensive Review of <i>Candidozyma (Candida) auris</i> Management: Insights From the Society of Infectious Diseases Pharmacists

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · 2026-03-12

Candidozyma (Candida) auris has emerged over the past two decades as a formidable global health threat due to its multidrug resistance, persistence in healthcare environments, and rapid nosocomial spread. Recently reclassified into the genus Candidozyma based on phylogenomic analysis, C. auris poses major challenges for both clinical management and infection control. Its ability to tolerate heat, salinity, and disinfectants supports long-term survival on surfaces and medical devices, facilitating transmission. Biofilm formation further enhances virulence and resistance to antifungal therapy. Clinical presentations range from asymptomatic colonization to invasive infections, with mortality rates approaching 50%. Echinocandins remain an important first-line treatment option, but their fungistatic activity, limited tissue penetration, and emerging resistance contribute to suboptimal outcomes, highlighting the need for new agents and optimized dosing strategies. The role of triazoles and amphotericin B is significantly limited by resistance and associated toxicities, while newer agents such as ibrexafungerp, fosmanogepix, and rezafungin show promising in vitro activity but lack substantial supporting clinical data. Combination therapy may also offer potential benefit, though supporting evidence is sparse. Infection control methods including active surveillance, contact precautions, and environmental disinfection with sporicidal agents and avoidance of ineffective quaternary ammonium compounds are key to preventing the nosocomial spread of C. auris. Despite growing awareness, effective decolonization strategies are lacking, and recurrence and transmission continue to pose challenges. Ongoing efforts to refine antifungal therapy, improve rapid diagnostics, and strengthen infection control practices are essential to mitigating the spread of this pathogen and optimizing outcomes for patients.

P-1795. Antimicrobial Stewardship Knowledge, Attitudes, and Practices (KAP) Among Health Care Providers in a Community Hospital Network

Open Forum Infectious Diseases · 2025-01-29

Abstract Background Drivers of inappropriate antimicrobial use (AU) and antimicrobial resistance (AMR) can be linked to deficiencies in prescribers’ knowledge, attitude, and practice (KAP) regarding antibiotics. Currently, KAP information in community hospitals throughout the United States (US) is not well known, and survey information is not standardized. Understanding clinicians’ KAP regarding AU and AMR may provide valuable information for improving antimicrobial stewardship (AS) efforts.Figure 1 Methods Prescribers, pharmacists, nurses, and administrators at 40 community hospitals within the Duke Antimicrobial Stewardship Outreach Network (DASON) were invited to take an anonymous, voluntary, 41-question web-based IRB-approved AS KAP survey. This survey is an internationally validated tool translated for use in the US (www.oucru.org/wp-content/uploads/2023/10/KAP_tool.pdf). Responses were collected via REDCap from Feb – Apr 2024.Figure 2 Results A total of 167 survey responses were received from 24 hospitals; 77 (46%) were pharmacists, 62 (37%) were nurses, and 16 (10%) were physicians. Respondents had a median of 15 years (15.3) of experience in their current healthcare profession and 8.5 years (14.3) in their current institution. Most respondents were familiar with AS (74.3%), strongly agree that antimicrobial overuse can cause harm (79.6%), and that appropriate antibiotic use can reduce AMR (74.3%) (Fig 1). More than half of the respondents who prescribe antibiotics agreed that education and feedback via peer comparison or direct feedback would improve their prescribing (Fig 2). Prescribing respondents also agreed that AS teams impact their antibiotic decisions (87.5%). 63% of prescribers and 46% of non-prescribers agreed antibiotics are overused at their institution. Providers were the most likely to agree AMR is a problem at their institutions (Fig 3).Figure 3 Conclusion Healthcare workers within DASON were aware of the importance of AS and its effect on AMR and patient outcomes. Prescriber feedback was seen as a valuable educational tool, as most prescribers valued AS feedback and agreed feedback would improve antibiotic selection. Disclosures Melissa D. Johnson, PharmD MHS AAHIVP, Biomeme: Licensed Technology|Scynexis, Inc: Grant/Research Support|UpToDate: Author Royalties Elizabeth Dodds Ashley, PharmD, MHS, HealthtrackRx: Advisor/Consultant|UpToDate: Royalties

Current Antifungals and the Developing Pipeline

Infectious Disease Clinics of North America · 2025-03-01 · 9 citations

Co-administration of triazoles with calcineurin or mammalian target of rapamycin inhibitors in solid organ transplant patients hospitalized with invasive aspergillosis

Journal of Antimicrobial Chemotherapy · 2025-12-03

BACKGROUND: All triazoles decrease the metabolism of calcineurin inhibitors (CNIs) and mammalian target of rapamycin (mTOR) inhibitors through CYP3A4 and P-glycoprotein inhibition leading to increased exposure and the potential for serious adverse events (SAEs). OBJECTIVES: We sought to describe triazoles and CNI and mTOR inhibitor use in solid organ transplantation (SOT) recipients hospitalized for invasive aspergillosis (IA). PATIENTS AND METHODS: We included adults with ≥1 claim for an IA admission in a US claims database from October 2015 to November 2022 who received systemic antifungal therapy for ≥3 days during the stay. This cohort was limited to patients with a history of SOT (defined as ≥1 diagnosis code for post-transplant status and/or complication) between January 2010 and IA admission. Triazoles and CNI or mTOR inhibitor co-administration in newly admitted IA patients were described. RESULTS: We identified 173 admitted IA patients with SOT. Kidney and lung transplant were most prevalent (>42% for both). Triazoles were used in 170 (98.3%) of patients (mean duration, 116 ± 184 post-admission days). Voriconazole (71.1%) and isavuconazole (41.0%) were most prescribed, and triazoles were co-administered with a CNI or mTOR inhibitor in 139 (81.8%) of patients. Tacrolimus was the predominantly used (89.9%) immunosuppressant. CONCLUSIONS: Voriconazole was used nearly twice as frequently as isavuconazole, despite isavuconazole having more predictable pharmacokinetics and a lower propensity for severe drug-drug interactions versus voriconazole. The still-frequent use of isavuconazole may reflect its lower inhibition of CNIs and mTOR inhibitors. Resulting drug-drug interactions may be serious and dose adjustment and therapeutic drug monitoring are needed to reduce SAEs.

Healthcare Resource Utilization, Total Healthcare Costs and Mortality in Patients with Invasive Aspergillosis and a History of Transplant

American Journal of Transplantation · 2025-08-01

Healthcare Resource Utilization, Treatment Costs, and Mortality in Patients with Malignancies or Transplantation Who Develop Invasive Aspergillosis

Journal of Fungi · 2025-09-06 · 1 citations

Objectives: Invasive aspergillosis (IA) poses significant risks to patients with malignancies or transplantation; however, estimates of burden-of-illness in patients with IA are sparse. We sought to assess in-hospital and outpatient healthcare resource utilization, all-cause treatment costs, and mortality in patients admitted with IA with hematologic or non-hematologic malignancies, bone marrow transplant/hematopoietic cell transplantation (BMT/HCT), or solid organ transplantation (SOT). Methods: This claims study utilized United States IQVIA data. Adults admitted for IA were identified by diagnosis codes during the patient selection period (October 2015–November 2022). IA patients were stratified into cohorts including recent hematologic or non-hematologic malignancies, or a history of BMT/HCT or SOT. We assessed hospital and intensive care unit (ICU) length-of-stay (LOS), all-cause index hospital treatment costs, and inpatient mortality or need for hospice in each cohort, as well as the need for re-admission and total treatment costs for up to six-months after admission, and all-cause mortality at end of study follow-up. Results: Among 1190 patients admitted for IA, 317 had hematologic malignancies, 155 non-hematologic malignancies, 133 BMT/HCT and 173 SOT. Across these cohorts, IA was associated with protracted (median LOS = 12–18 days; ICU LOS = 10–13 days) and costly (median = USD 79,058–USD 172,342) index hospitalizations ending in death or hospice in 28.1% (89/317) to 36.1% (48/133) of patients. Among those surviving to discharge, between 53.1% (34/64) and 63.4% (97/153) were re-admitted within six months. Total median treatment costs at six months ranged from USD 213,378 to USD 397,857. All-cause mortality was 33.6% (52/155) to 40.6% (54/133) at end of study follow-up. Conclusions: Hospitalizations for IA in patients with malignancies or transplantation are long, costly, and end with readmission, hospice, or death in more than one-third of patients.

Targeted antimicrobial use admission provides an actionable denominator for evaluating inpatient length of therapy

Antimicrobial Stewardship & Healthcare Epidemiology · 2025-01-01

Our novel antibiotic use denominator, targeted antimicrobial use admission, is defined as an inpatient admission in which a select agent or group of agents is administered. Used in combination with length of therapy, it allows programs to quickly assess agent inpatient durations.

583. Increasing Diversity, Equity, and Inclusion in the Antimicrobial Stewardship Workforce through the SIDP Certificate Program

Open Forum Infectious Diseases · 2025-01-29

Abstract Background A diverse workforce provides opportunities for patients to be served by healthcare practitioners sharing a common race, ethnicity, culture, language, or disability. The Society of Infectious Disease Pharmacists (SIDP) aims to increase engagement in an Antimicrobial Stewardship Certificate Program (ASCP) among clinicians identifying with underrepresented minoritized (URM) groups to increase workforce diversity, equity and inclusion; reduce antimicrobial resistance; and improve outcomes. Methods SIDP updated and redesigned its long-standing ASCP in May 2023. Healthcare professionals identifying as URM were invited to apply for a scholarship to complete the ASCP, with planned enrollment of 130 participants over 3 years. Baseline data collection included demographics, motivation for training, anticipated challenges in completing the ASCP, and confidence in stewardship activities (Likert scale 1-5, with 5 as the highest level). Demographic data prior to May 2023 was not available. Results To date, 97 individuals received a scholarship and were enrolled. Most were pharmacists (65%), with allied health professionals comprising the remainder. Participants most commonly identified as Black or African American (29%), Hispanic or Latin descent (21%), and Asian (18%) (Table 1). Considering non-scholarship enrollments (among those reporting race/ethnicity) over the same time-period (n=385), the scholarship increased the proportion of total participants in the program identifying as Black or African American (11% v 6%), Hispanic or Latin descent (9% v 6%), and Middle East or North African (2% v 0%). Among scholarship recipients who started the program and received an entrance survey (n=45), 80% (n=36) responded. The most anticipated challenge for successfully completing the program was knowledge to design a quality improvement project (Figure1). Respondents reported the least confidence in ability to establish an antimicrobial stewardship program (Figure 2). Conclusion The scholarship program has increased the proportion of URM clinicians in the ASCP, resulting in a potentially more diverse workforce. Identifying and mitigating barriers to completion and assessing participant confidence in stewardship activities will inform additional program development. Disclosures Melissa D. Johnson, PharmD MHS AAHIVP, Biomeme: Licensed Technology|Scynexis, Inc: Grant/Research Support|UpToDate: Author Royalties Kenneth Lawrence, BS, PharmD, Seres Therapeutics: Employee Hermsen D. Elizabeth, PharmD, MBA, Pfizer, Inc.: Employee|Pfizer, Inc.: Stocks/Bonds (Public Company)