Antifungal prophylaxis to prevent invasive mycoses among bone marrow transplantation recipients.
We reviewed the effect of systemic, intranasal, and lipid formulations of amphotericin B, fluconazole, itraconazole for antifungal prophylaxis. Specifically we reviewed the effect of antifungal prophylaxis on the development of fungal colonization, frequency of superficial and invasive mycosis, and overall mortality and that due to invasive mycoses in bone marrow transplantation recipients. A MEDLINE search was conducted to identify literature describing the risk factors, epidemiology, and chemoprophylaxis of invasive mycosis in these patients. Preliminary data published as abstracts at national infectious diseases and hematology conferences within the last 5 years were included. Antifungal prophylaxis reduces fungal colonization and superficial infection. The ability of antifungal prophylaxis to prevent systemic infection or reduce the need for empiric amphotericin B depends on specific variables. Ultimately, antifungal prophylaxis has no affect on overall mortality, and very little impact on mortality attributed to fungi.
Gubbins
P O
PO
Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Bowman
J L
JL
Penzak
S R
SR
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D016026:Bone Marrow Transplantation; D002177:Candidiasis / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use; D016239:MEDLINE; D011183:Postoperative Complications / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole