Chemoprophylaxis of fungal infections in neutropenic patients.
BACKGROUND
In recent years there has been an increasing incidence and awareness of mucosal candidiasis and invasive fungal infections in neutropenic patients. Early diagnosis (before serious morbidity and mortality) is often difficult, emphasizing the continuing need for adequate prophylaxis.


METHODS
A review of studies on the chemoprophylaxis of fungal infections in neutropenic patients.


RESULTS
There is a limited number of large, prospective, well-designed studies using proper criteria and end points. No antifungal drug or drug combination has been shown to prevent invasive fungal infection with the exception of fluconazole (mainly Candida Albicans infections) in certain high-risk patients groups.


CONCLUSIONS
Prophylaxis strategies are dependent upon local conditions, patient populations, types of therapies, available resources, etc. Future improvement will be based upon a) improved study quality, b) new strategies for established drugs, c) development of new and safer drugs, d) new strategies to eliminate or reduce immunosuppression and e) cost-benefit studies.
Björkholm
M
M
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
D000935:Antifungal Agents / Q000627:therapeutic use*; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D009181:Mycoses / Q000150:complications / Q000517:prevention & control*; D009503:Neutropenia / Q000150:complications*; D011090:Polyenes / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use
D000935:Antifungal Agents; D007093:Imidazoles; D011090:Polyenes; D014230:Triazoles; D005437:Flucytosine