837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis

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Abstract Background Coccidioidomycosis is a fungal infection with a range of clinical manifestations. Currently used antifungal agents exhibit variable efficacy and toxicity profiles necessitating evaluation of additional therapeutic options. Methods Patients with coccidioidomycosis who received Isavuconazole were identified by cross-indexing ICD-9 and ICD-10 codes from patients and data abstracted. Responses to Isavuconazole therapy were measured using a modified Mycoses Study Group Coccidioidomycosis Scoring system as described previously. Results 82 patients met the criteria for inclusion. Over half of the patient exhibited pulmonary involvement 45/82 (55%), although meningitis 32/82 (39%), bone and joint disease 14/82 (17%) and skin/soft tissue infection 7/82 (9%) were also seen. The majority of patients experienced a decrease in their MSG score following initiation of Isavuconazole therapy (median MSG score change across all patient groups 7 → 2, p< 0.0001). Overall improvement was noted in 58/82 (71%) patients, while no change was observed in 19/82 (23%) and 5/82 (6%) who were unresponsive to antifungal changes. Conclusion Isavuconazole demonstrated efficacy in the majority of patients treated, with failures observed only in a subgroup of patients with coccidioidal meningitis. Disclosures Rupam Sharma, PGY-1/MD, Astellas: Grant/Research Support George R. Thompson, III, MD, Astellas: Advisor/Consultant|Astellas: Grant/Research Support|Cidara: Advisor/Consultant|Cidara: Grant/Research Support|F2G: Advisor/Consultant|F2G: Grant/Research Support|Mayne: Advisor/Consultant|Mayne: Grant/Research Support|Melinta: Advisor/Consultant|Melinta: Grant/Research Support|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support

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