TY - JOUR
T1 - Adherence to international guidelines for the treatment of invasive aspergillosis in acute myeloid leukaemia: feasibility and utility (SEIFEM-2008B study).
AU - Pagano, Livio
AU - Caira, Morena
AU - Valentini, Caterina Giovanna
AU - Leone, Giuseppe
PY - 2010
Y1 - 2010
N2 - Objectives and methods: In order to assess physicians’ compliance with international guidelines for the targeted
treatment of invasive aspergillosis, 136 patients with acute myeloid leukaemia and proven/probable invasive
aspergillosis were analysed.
Results: Compliance with Infectious Diseases Society of America (IDSA) and European Conference on Infections
in Leukaemia (ECIL) guidelines was found to be relatively low (28% for ECIL and 55% for IDSA), although no
significant differences were found between the two groups (adherence versus non-adherence). In both subgroup
analyses (IDSA and ECIL), compliance with the guidelines did not impact the 120 day survival rate.
Instead, adherence to guidelines led to a higher response rate to first-line antifungal treatment (76% in the
IDSA group and 84% in the ECIL group).
Conclusions: Guidelines establish categories of patients with homogeneous characteristics, and suggest
optimal diagnostic and therapeutic options for them. Acquisition of good results through adherence to guidelines
is confirmed by our series. Unfortunately, there are frequently reasons to deviate from these general recommendations,
particularly in patients with acute myeloid leukaemia. Despite evidence-based
recommendations, adherence to the guidelines does not constitute the best therapeutic choice in each and
every patient. Subjects’ clinical conditions and co-morbidities vary widely, and sometimes render the ‘recommended’
drug a non-applicable strategy.
AB - Objectives and methods: In order to assess physicians’ compliance with international guidelines for the targeted
treatment of invasive aspergillosis, 136 patients with acute myeloid leukaemia and proven/probable invasive
aspergillosis were analysed.
Results: Compliance with Infectious Diseases Society of America (IDSA) and European Conference on Infections
in Leukaemia (ECIL) guidelines was found to be relatively low (28% for ECIL and 55% for IDSA), although no
significant differences were found between the two groups (adherence versus non-adherence). In both subgroup
analyses (IDSA and ECIL), compliance with the guidelines did not impact the 120 day survival rate.
Instead, adherence to guidelines led to a higher response rate to first-line antifungal treatment (76% in the
IDSA group and 84% in the ECIL group).
Conclusions: Guidelines establish categories of patients with homogeneous characteristics, and suggest
optimal diagnostic and therapeutic options for them. Acquisition of good results through adherence to guidelines
is confirmed by our series. Unfortunately, there are frequently reasons to deviate from these general recommendations,
particularly in patients with acute myeloid leukaemia. Despite evidence-based
recommendations, adherence to the guidelines does not constitute the best therapeutic choice in each and
every patient. Subjects’ clinical conditions and co-morbidities vary widely, and sometimes render the ‘recommended’
drug a non-applicable strategy.
KW - aspergillosis
KW - leukemia
KW - aspergillosis
KW - leukemia
UR - http://hdl.handle.net/10807/3822
M3 - Article
SN - 0305-7453
VL - 2010
SP - 2013
EP - 2018
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
ER -