Advances in antifungal prophylaxis and empiric therapy in patients with hematologic malignancies

Transpl Infect Dis. 2009 Dec;11(6):480-90. doi: 10.1111/j.1399-3062.2009.00441.x. Epub 2009 Sep 1.

Abstract

Invasive fungal infection (IFI) is associated with significant morbidity and mortality in patients with hematologic malignancies. There have been significant changes in the epidemiology and outcomes of IFI in this patient population, due in part to advances in transplant procedures, supportive care, and use of newer antifungal agents. A thorough knowledge of risk factors, potential causative organisms, and the safety and efficacy of appropriate antifungal agents is required to optimize treatment. Proper diagnosis of IFI is challenging and the correlation of delays in diagnosis and treatment with poor outcome suggest that earlier intervention may result in more effective management of high-risk patients. Because all risks may not be equal, stratifying high-risk patients may further help target patients most likely to benefit from prophylaxis. This review focuses on various risk factors specific to patients with hematologic malignancies and discusses the use of preemptive, empiric, and prophylactic strategies in the management of IFI in this patient population.

Publication types

  • Review

MeSH terms

  • Antibiotic Prophylaxis
  • Antifungal Agents / therapeutic use*
  • Aspergillosis / drug therapy
  • Aspergillosis / epidemiology
  • Aspergillosis / etiology
  • Aspergillosis / prevention & control
  • Candidiasis / drug therapy
  • Candidiasis / epidemiology
  • Candidiasis / etiology
  • Candidiasis / prevention & control
  • Hematologic Neoplasms / complications
  • Humans
  • Mycoses / drug therapy
  • Mycoses / epidemiology
  • Mycoses / microbiology
  • Mycoses / prevention & control*
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • Antifungal Agents