Management of invasive mycoses in hematology patients: current approaches.

Published

Journal Article (Review)

Candidiasis and aspergillosis are the most common fungal infections in hematopoietic stem cell transplant recipients and other hematology/oncology patients. Strategies for reducing the morbidity and mortality associated with these infections include antifungal prophylaxis, empiric therapy in patients with persistent fever and neutropenia, and preemptive therapy. Antifungal therapies include amphotericin B deoxycholate, lipid formulations of amphotericin B, the triazoles (fluconazole, itraconazole, and voriconazole), and the echinocandins (caspofungin and the investigational agents micafungin and anidulafungin). Fluconazole is a reasonable choice for the treatment of invasive candidiasis if the patient has not previously received a triazole and the institution has a low incidence of triazole resistance. If resistance is a concern, an echinocandin, such as caspofungin, is an appropriate option. Voriconazole may be the initial choice in most patients with invasive aspergillosis. If patients are intolerant of or refractory to conventional therapy, effective alternatives include a lipid formulation of amphotericin B or an echinocandin.

Full Text

Duke Authors

Cited Authors

  • Perfect, JR

Published Date

  • November 2004

Published In

Volume / Issue

  • 18 / 13 Suppl 7

Start / End Page

  • 5 - 14

PubMed ID

  • 15651177

Pubmed Central ID

  • 15651177

International Standard Serial Number (ISSN)

  • 0890-9091

Language

  • eng

Conference Location

  • United States