The role of primary antifungal prophylaxis in patients with haematological malignancies

Clin Microbiol Infect. 2014 Jun:20 Suppl 6:19-26. doi: 10.1111/1469-0691.12464. Epub 2014 Feb 3.

Abstract

Invasive fungal infections (IFIs) represent important complications in patients with haematological malignancies. Chemoprevention of IFIs may play an important role in this setting, but in the past decades the majority of antifungal drugs utilized demonstrated poor efficacy, particularly in the prevention of invasive aspergillosis. The new triazoles are very useful antifungal drugs, more suitable for prophylaxis of IFIs than amphotericin B and echinocandins. In this review, the main clinical data about antifungal prophylaxis with fluconazole, itraconazole, voriconazole and posaconazole are analysed. At present, posaconazole appears to be the most efficacious azole in antifungal prophylaxis, particularly in patients with acute myeloid leukaemia.

Keywords: antifungal prophylaxis; fluconazole; itraconazole; leukaemia; posaconazole; stem cell transplantation; voriconazole.

Publication types

  • Review

MeSH terms

  • Administration, Intravenous
  • Antibiotic Prophylaxis*
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Hematologic Neoplasms / complications*
  • Humans
  • Meta-Analysis as Topic
  • Mycoses / epidemiology
  • Mycoses / etiology*
  • Mycoses / prevention & control*
  • Practice Guidelines as Topic
  • Triazoles / administration & dosage
  • Triazoles / therapeutic use

Substances

  • Antifungal Agents
  • Triazoles