Findings from Mycotic Diseases Branch Broaden Understanding of Coccidioidomycosis (Impact of Fluconazole On Outcomes of Patients With Primary Pulmonary Coccidioidomycosis: a Commercial Health Insurance Claims-based, Propensity Score Matched …): Fungal Diseases and Conditions – Coccidioidomycosis

2025 MAR 19 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A new study on Fungal Diseases and Conditions - Coccidioidomycosis is now available. According to news originating from Atlanta, Georgia, by NewsRx correspondents, research stated, “Patients with pulmonary coccidioidomycosis often experience prolonged symptoms lasting weeks to months. Limited data exist regarding whether fluconazole prevents development of disseminated disease or shortens symptom duration.”

Our news journalists obtained a quote from the research from Mycotic Diseases Branch, “We describe factors associated with fluconazole receipt and assess its effect on outcomes among patients with pulmonary coccidioidomycosis. Using the MerativeTM MarketScan ® Commercial Database, we identified immunocompetent patients ages 18-64 with incident pulmonary coccidioidomycosis during 2017-2023 and continuous enrollment in the 180 days before and after diagnosis. We examined demographic and clinical differences between patients treated vs. not treated with fluconazole and performed 1:1 greedy nearest neighbor propensity score matching to control for these differences. We performed bivariate analyses on the matched subset to evaluate patient outcomes by fluconazole receipt. Among 1,448 patients with pulmonary coccidioidomycosis, 659 (46%) received fluconazole. Patients who received fluconazole more frequently had pre-diagnosis symptoms (95% vs. 72%, p<0.001) and antibiotic prescriptions (68% vs. 32%, p<0.001) than those who did not. Among the propensity score matched subset (n=696), hospitalization (4% vs. 1%, p=0.004) and disseminated coccidioidomycosis (3% vs. 0%, p=0.006) were more frequent among patients who received fluconazole. The median number of days from diagnosis to last visit for chest pain (50.0 vs. 46.5), cough (64.0 vs. 39.0), fatigue (63.0 vs. 65.5), myalgia (98.0 vs. 74.0), and joint pain (93.5 vs. 107.5) was not significantly different between treatment groups.”

According to the news editors, the research concluded: “Our results support existing guidelines that fluconazole may not be associated with improved outcomes for certain immunocompetent patients with pulmonary coccidioidomycosis.”

This research has been peer-reviewed.

For more information on this research see: Impact of Fluconazole On Outcomes of Patients With Primary Pulmonary Coccidioidomycosis: a Commercial Health Insurance Claims-based, Propensity Score Matched Analysis. Clinical Infectious Diseases, 2025. Clinical Infectious Diseases can be contacted at: Oxford Univ Press Inc, Journals Dept, 2001 Evans Rd, Cary, NC 27513, USA. (Oxford University Press - http://www.oup.com/; Clinical Infectious Diseases - cid.oxfordjournals.org)

The news correspondents report that additional information may be obtained from Kaitlin Benedict, Cdcp, Mycotic Diseases Branch, Division of Foodborne Waterborne and Environmental Diseases, Natl Ctr Emerging & Zoonot Infect Dis, Atlanta, GA, United States. Additional authors for this research include Ian Hennessee, Dallas J. Smith, Mitsuru Toda and George R. Thompson.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1093/cid/ciaf036. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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