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- Title
Current Strategies in Antifungal Therapy for Invasive Aspergillosis in Immunocompromised Patients Following Hematopoietic Stem Cell Transplantation.
- Authors
Chakhtoura, Nadim G. El; Kanafani, Zeina A.
- Abstract
Shifting epidemiological trends in invasive fungal infections (IFI) have recently surfaced, with an increase in mould infections, which currently constitute the bulk of IFI. Many changes have contributed to this shift, including the widespread use of fluconazole prophylaxis, which successfully prevents Candida infections but not other IFI, as well as recent advances in hematopoietic stem cell transplant (HSCT) practices, with ever-growing immunosuppressive protocols and treatments for graft-versus-host disease. Allogeneic HSCT recipients are the subset of patients at the greatest risk, with an incidence of proven or probable IFI of 5-18% and a crude mortality rate of 70-93%. These alarming numbers have triggered unprecedented research into preventing these infections as well as identifying antifungal agents or combinations that would prove successful for treatment in such a high-risk population. In this review, the available evidence behind the use of various antifungal agents and their combinations as first-line, salvage, and prophylactic therapies for invasive aspergillosis (IA), with a special interest in HSCT recipients, is assessed. Various approaches for the management of such patients with IA in an era of growing antifungal resistance and development of new antifungal agents are also evaluated.
- Publication
Journal of Invasive Fungal Infections, 2010, Vol 4, Issue 2, p54
- ISSN
1753-3783
- Publication type
Academic Journal