title: [Cross-sectional investigation of first-choice of antifungal agents in empirical and preemptive antifungal therapy for patients with hematological malignancies].
abstract: OBJECTIVE
  To describe the constituent ratio of different kinds of antifungal agents as first choice in empirical or preemptive antifungal therapy for patients with hematological malignancies received chemotherapy or hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Between 2008 January and 2009 December, 367 patients received chemotherapy or HSCT from 15 medical centers in China were collected. The strategies of antifungal therapy and the first-choice antifungal agents were analyzed.
  
  
  RESULTS
  Of them, 282(76.8%) patients received empirical antifungal therapy, 85(23.2%) preemptive therapy. The number of first choice antifungal agents were 55(15.0%) of fluconazole, 174(47.4%) of itraconazole, 39(10.6%) of voriconazole, 57(15.5%) of traditional/lipid formulation amphotericin B, 26(7.1%) of caspofungin, 7(1.9%) of micafungin, and 9(2.5%) of combination antifungal therapy respectively. Moreover, voriconazole and combination antifungal agents were more often selected for preemptive antifungal therapy, while the probabilities of itraconazole were the highest in both empirical and preemptive strategies. More patients undergoing HSCT were first given itraconazole or caspofungin for antifungal therapy, while amphotericin B, fluconazole and voriconazole were more administered in patients received chemotherapy. Caspofungin and combined antifungal agents were more often used for patients with secondary antifungal prophylaxis, while itraconazole was usually used for patients with no prophylaxis or primary antifungal prophylaxis.
  
  
  CONCLUSIONS
  Empirical antifungal therapy was more administered in hematological malignancies patients received chemotherapy or HSCT. Itraconazole was the most commonly used agent for antifungal therapy followed by amphotericin, fluconazole, voriconazole and echinocandin agents.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Lab of HSCT, Beijing 100044, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ji
authors.forename: Lan-ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis; D000935:Antifungal Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents