Recommendations for therapy of invasive fungal disease in patients with hematological malignancy or undergoing hematopoietic stem cell transplantation
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 6
Abstract
Invasive fungal disease (IFD) is one of the most serious infectious complications and cause of morbidity in patients with hematological malignancies, severe immune deficiencies and in patients after stem cell transplantation. Currently available antifungal drugs used in therapy of IFD include 4 groups: polyens (amphotericin B), azoles (fluconazole, itraconazole, voriconazole, posaconazole), echinocandins (caspofungin, micafungin, anidulafungin) and antimetabolites (flucytosine).The objective of this review is the presentation of drugs used in therapy of IFD and current European guidelines of ECIL (European Conference on Infections in Leukemia) group for their administration for antifungal prophylaxis and targeted therapy in candidiasis, aspergillosis, mucormycosis, fusariosis and scedosporiosis. Echinocandines are the first line therapy in cadidemia or invasive candidiasis. Voriconazole and lipid forms of am photericin B are the first line therapy antifungals in invasive aspergillosis. Primary therapy in invasive mucormycosis consists of control of underlying disease, surgical debridement of infectious site and antifungal therapy with lipid forms of amphotericin B or posaconazole. Recommendations for therapy of invasive hyalohyphomycosis including fusariosis or scedosporiosis, are based on liposomal amphotericin B or voriconazole.
Authors and Affiliations
Katarzyna Dzierżanowska-Fangrat, Lidia Gil, Beata Jakubas, Sławomira Kyrcz-Krzemień, Jan Styczyński
Keywords
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