title: [Prophylaxis and treatment of invasive fungal infection in neutropenic patients].
abstract: Prophylaxis and treatment constitute the basis for reducing the mortality due to IFI. Prophylaxis is currently the standard practice in most hospitals and is recommended by the principal guidelines. Fluconazole has proved to be useful to prevent and reduce the mortality due to yeast IFI in several contexts. Although its use has led to the emergence of some resistant strains of Candida, it has not been a generalized problem and the number of lives saved has been worth it. But its major disadvantage is the lack of impact on IFI by molds. So, in patients at high risk for IFI due to filamentous fungi, it is necessary the employ of extended spectrum drugs. For the empirical and preemptive approach, it is necessary to have in mind which fungi have to be covered and the spectrum of the available antifungal agents. For the treatment of established infection by Candida spp., before the identification of species, we must consider different host (like the use or not of prophylactic fluconazole) and clinical factors (like the evidence or not of diseminated infection or severe sepsis). Primary combination of antifungal agents for the treatment of invasive aspergillosis has to be considered in cases of central nervous system disease, respiratory failure, serious sepsis, and extensive or cavitated pulmonary lesions.
authors.affiliation: Hospital Central de Asturias. Oviedo, Spain. carlosvallej@gmail.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Vallejo
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D006801:Humans; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D009503:Neutropenia / Q000150:complications*; D016377:Organ Transplantation
chemical_list: D000935:Antifungal Agents