Recent progress and current problems in treatment of invasive fungal infections in neutropenic patients.
Invasive fungal infections, including disseminated candidiasis and invasive pulmonary aspergillosis, are important causes of morbidity and mortality in neutropenic patients. The recent development of fluconazole, itraconazole, lipid formulations of amphotericin B, and recombinant cytokines have expanded our therapeutic armamentarium. Clinical trials have elucidated new strategies for utilizing these compounds in the prevention and treatment of opportunistic mycoses. The population of more severely immunocompromised patients, however, continues to expand and the spectrum of drug-resistant fungi, including but not limited to Candida spp, Fusarium spp, Zygomycetes, and dematiaceous moulds, continues to evolve, thus presenting new challenges to recent therapeutic advances. Development of new antifungal chemotherapeutic agents and novel approaches for augmentation of host response will be required to meet these new mycologic challenges.
Walsh
T J
TJ
Infectious Diseases Section, National Cancer Institute, Bethesda, Maryland, USA.
Hiemenz
J W
JW
Anaissie
E
E
D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy; D016207:Cytokines / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D009503:Neutropenia / Q000150:complications* / Q000276:immunology; D009894:Opportunistic Infections / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use
D000935:Antifungal Agents; D016207:Cytokines; D011994:Recombinant Proteins