Pharmacotherapy approaches to antifungal prophylaxis.
BACKGROUND
Invasive fungal infection (IFI) is a serious problem due to difficulties in early diagnosis and high mortality. Different approaches are adopted for the treatment and management of IFI, including prophylactic, empiric, preemptive and directed strategies.


METHODS
This paper reviews the type of pharmacotherapy used for antifungal prophylaxis in infants with extremely low birth weights, pediatric patients with cardiac disease, preterm neonates, pediatric oncology patients, adult cancer patients with neutropenia, adult patients with hematologic malignancy, hematopoietic stem-cell transplantation recipients, organ transplant recipients, HIV-infected patients, immunosuppressed patients treated with moderate or high doses of corticosteroids, and patients with invasive fusariosis, candidemia, invasive candidiasis, systemic mycoses and immunocompromised patients.


CONCLUSIONS
Azole drugs are the drugs most often used in cost-effective antifungal prophylaxis of patients with conditions such as immunodeficiency and cancer, which render them highly susceptible to IFI. Fluconazole is the most outstanding example. However, there are many azoles with different pharmacological characteristics that the physician can choose from. Echinocandins have favorable characteristics that make them useful for treating Candida infections. Antibodies, or their engineered derivatives directed against cell-wall polysaccharides and glycopeptides, and some protein epitopes of Candida albicans, appear to be a promising novel approach for prophylaxis against Candida infection and deserve further in-depth investigations.
School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. b021770@mailserv.cuhk.edu.hk
Tzi Bun
TB
Ng
Randy Chi Fai
RC
Cheung
Xiu juan
Xj
Ye
Evandro Fei
EF
Fang
Yau Sang
YS
Chan
Wen Liang
WL
Pan
Xiu Li
XL
Dan
Cui Ming
CM
Yin
Sze Kwan
SK
Lam
Peng
P
Lin
Patrick Hung Kui
PH
Ngai
Li Xin
LX
Xia
Fang
F
Liu
Xiu Yun
XY
Ye
He Xiang
HX
Wang
Jack Ho
JH
Wong
D000935:Antifungal Agents / Q000627:therapeutic use*; D001393:Azoles / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000517:prevention & control*
D000935:Antifungal Agents; D001393:Azoles