Antifungal Prophylaxis In Hematopoietic Stem Cell Transplant Recipients
Journal Title: Macedonian Journal of Medical Sciences (MJMS) - Year 2008, Vol 1, Issue 1
Abstract
Background. According to immunological deficit the period after hematopoietic stem cell transplantation (HSCT) can be divided in three phases: aplastic phase, phase of acute GVHD, and phase of chronic GVHD. Fungal infections are predominant in first, aplastic phase. Deep neutropenia and implantation of central venous catheter are two major risk factors contributing to infection. Aim. To retrospectively analyze fungal infections, fungal isolates and to compare success of different antifungal strategies during the first 30 days after HSCT. Material and methods. During a 7 year period (2000-2007), we have performed 128 HSCT in 120 patients with different hematological diseases. Male: 62 Female: 58. Median age: 34 years. Patients were treated in sterile room, conditioned with HEPA filters, and low microbes diet. Antifungal prophylaxis with Fluconazole 200mg, Itraconazole 200mg, or combination Fluconazole200/Itraconazole 200 (in high-risk patients) was administered from day 0 until day +100. Results. Patients treated with combination of Fluconazole200/Itraconazol200 have had only few oropharyngeal candidiasis, without signs of invasive fungal infection. There is no statistically significant difference between the prophylaxis with Fluconazole and Itraconazole, (p=0,302). Non-Albicans Candida is predominantly isolated funga (Non-Albicans Candida vs. Candida Albicans: 54% vs. 46%). There is no isolation of Aspergillus during the first phase after HSCT in our group of patients. Concluson. The rising incidence of invasive fungal infections and the currently problematic early diagnosis call for an intensive exploration of new drugs and further developments in diagnosis and treatment of invasive fungal infection.
Authors and Affiliations
Zlate Stojanoski| Hematology Clinic, Medical Faculty, University St’s Cyril and Methodius, Skopje, Aleksandra Pivkova| Hematology Clinic, Medical Faculty, University St’s Cyril and Methodius, Skopje, Sonja Genadieva-Stavrik| Hematology Clinic, Medical Faculty, University St’s Cyril and Methodius, Skopje, Lidija Cevreska| Hematology Clinic, Medical Faculty, University St’s Cyril and Methodius, Skopje, Milena Petrovska| Institute of Microbiology and Parazitology, Medical Faculty, University St’s Cyril and Methodius, Skopje, Republic of Macedonia, Borche Georgievski| Hematology Clinic, Medical Faculty, University St’s Cyril and Methodius, Skopje
Keywords
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- EP ID EP8587
- DOI 10.3889/MJMS.1857-5773.2008.0002
- Views 527
- Downloads 25
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