title: Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2014.
abstract: There is a strong argument for the use of antifungal prophylaxis in high-risk patients given the significant mortality associated with invasive fungal disease, the late identification of these infections, and the availability of safe and well-tolerated prophylactic medications. Clinical decisions about which patients should receive prophylaxis and choice of antifungal agent should be guided by risk stratification, knowledge of local fungal epidemiology, the efficacy and tolerability profile of available agents, and estimates such as number needed to treat and number needed to harm. There have been substantial changes in practice since the 2008 guidelines were published. These include the availability of new medications and/or formulations, and a focus on refining and simplifying patient risk stratification. Used in context, these guidelines aim to assist clinicians in providing optimal preventive care to this vulnerable patient demographic.
authors.affiliation: Malignant Haematology and Stem Cell Transplantation Service, Alfred Health, Prahran, Victoria.
authors.forename: S
authors.initials: S
authors.lastname: Fleming
authors.forename: C K
authors.initials: CK
authors.lastname: Yannakou
authors.forename: G M
authors.initials: GM
authors.lastname: Haeusler
authors.forename: J
authors.initials: J
authors.lastname: Clark
authors.forename: A
authors.initials: A
authors.lastname: Grigg
authors.forename: C H
authors.initials: CH
authors.lastname: Heath
authors.forename: A
authors.initials: A
authors.lastname: Bajel
authors.forename: S J
authors.initials: SJ
authors.lastname: van Hal
authors.forename: S C
authors.initials: SC
authors.lastname: Chen
authors.forename: S T
authors.initials: ST
authors.lastname: Milliken
authors.forename: C O
authors.initials: CO
authors.lastname: Morrissey
authors.forename: C S
authors.initials: CS
authors.lastname: Tam
authors.forename: J
authors.initials: J
authors.lastname: Szer
authors.forename: R
authors.initials: R
authors.lastname: Weinkove
authors.forename: M A
authors.initials: MA
authors.lastname: Slavin
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000517:prevention & control; D002177:Candidiasis / Q000517:prevention & control; D032921:Consensus; D003362:Cost-Benefit Analysis; D019983:Guideline Adherence; D019337:Hematologic Neoplasms / Q000150:complications / Q000276:immunology* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D008826:Microbial Sensitivity Tests; D009894:Opportunistic Infections / Q000382:microbiology* / Q000517:prevention & control*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D065129:Pre-Exposure Prophylaxis / Q000191:economics; D018570:Risk Assessment
chemical_list: D000935:Antifungal Agents
keywords: Aspergillus; Candida; antifungal prophylaxis; haematological malignancy; stem cell transplantation