Multisystem <i>Lomentospora prolificans</i> progression on fosmanogepix despite <i>in vitro</i> activity: a call for expanding clinical research on novel antifungals
This case underscores the limitations of relying on <i>in vitro</i> susceptibility results to predict clinical response in the absence of clinical breakpoints, particularly in deep-seated infections where drug penetration may be limited. While prior case reports have described successful outcomes with novel agents, publication bias may overrepresent favorable results. This case supports the urgent need for rigorous evaluation of emerging antifungal therapies in real-world settings.
Authors
- Mustafa Iftikhar (ORCID: https://orcid.org/0000-0002-1034-550X)
- R. G. Cooper
- Bin Ni (ORCID: https://orcid.org/0000-0001-7148-4653)
- Kelly Stanly
- Madeleine R. Heldman (ORCID: https://orcid.org/0000-0002-9424-1870)
- Brennan Collis (ORCID: https://orcid.org/0000-0002-9393-4536)
- Beatrice Sim (ORCID: https://orcid.org/0000-0003-1845-4476)
- Nathan P. Wiederhold (ORCID: https://orcid.org/0000-0002-2225-5122)
- Sana Arif
- Barbara D. Alexander
- John R. Perfect
- Arthur W. Baker
- Stefanie Sarantopoulos
Institutions
- Duke University (US)
- Duke Energy (United States) (US)
- Duke Medical Center (US)
- Cellular Therapeutics (United Kingdom) (GB)
- The University of Texas Health Science Center at Tyler (US)
Publication Details
- Journal
- ASM Case Reports
- Published
- 2026-01-29
- DOI
- https://doi.org/10.1128/asmcr.00189-25
- Primary Topic
- Antifungal resistance and susceptibility
- Type
- article
- Field-Weighted Citation Impact
- 0.00