Antifungal therapy in febrile neutropenic patients: review of treatment choices and strategies for aspergillar infection.
BACKGROUND
Invasive fungal infections, especially aspergillosis, are a major problem in patients who undergo aggressive therapy for haematological malignancies. Presently, the standard therapy for demonstrated aspergillar infection is voriconazole. Because the morbidity and the mortality of proven aspergillar infection is relatively high, empirical and preemptive approaches have been explored.


RESULTS
Empirical therapy is effective at the cost of overtreatment in a significant number of patients. This can be reduced through the preemptive approach; however, its equivalence in terms of successful therapy and mortality should be studied further and, optimally, in prospective controlled clinical trials.
Klastersky
Jean
J
Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, 1, rue Héger-Bordet, 1000, Bruxelles, Belgium.
Paesmans
Marianne
M
D000935:Antifungal Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000276:immunology; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D000970:Antineoplastic Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole