TY - JOUR
T1 - Prophylaxis for aspergillosis in patients with haematological malignancies: pros and cons
AU - Busca, Alessandro
AU - Pagano, Livio
PY - 2018
Y1 - 2018
N2 - Introduction: Along with new diagnostic options, comes the recent development of novel antifungal agents that expanded the spectrum of activity over traditional treatments contributing to the successful management of fungal diseases. Nevertheless, invasive fungal infections (IFI) represent a major hindrance to the favorable outcome of patients with hematologic malignancies. According to these observations, an appropriate prevention of IFI occurring in hematologic patients should be considered of paramount importance. However, the wide use of antifungal agents may facilitate the emergence of resistance and may be associated to the occurrence of severe adverse events and eventually may significantly increase the cost of therapeutic procedures. Areas covered: The aim of present review is to analyze advantages and disadvantages of primary antifungal prophylaxis (PAP) in hematologic patients. Expert commentary: Patients with AML/MDS undergoing intensive chemotherapy and patients receiving stem cell transplantation are at high risk of IFI, and therefore may benefit form PAP, although several additional factors should be carefully evaluated in our decision-making approach, including the local epidemiology and the prompt availability of diagnostic facilities. The advent of new treatment options for hematologic patients such as target therapies might facilitate the rise of new risk categories so far underestimated.
AB - Introduction: Along with new diagnostic options, comes the recent development of novel antifungal agents that expanded the spectrum of activity over traditional treatments contributing to the successful management of fungal diseases. Nevertheless, invasive fungal infections (IFI) represent a major hindrance to the favorable outcome of patients with hematologic malignancies. According to these observations, an appropriate prevention of IFI occurring in hematologic patients should be considered of paramount importance. However, the wide use of antifungal agents may facilitate the emergence of resistance and may be associated to the occurrence of severe adverse events and eventually may significantly increase the cost of therapeutic procedures. Areas covered: The aim of present review is to analyze advantages and disadvantages of primary antifungal prophylaxis (PAP) in hematologic patients. Expert commentary: Patients with AML/MDS undergoing intensive chemotherapy and patients receiving stem cell transplantation are at high risk of IFI, and therefore may benefit form PAP, although several additional factors should be carefully evaluated in our decision-making approach, including the local epidemiology and the prompt availability of diagnostic facilities. The advent of new treatment options for hematologic patients such as target therapies might facilitate the rise of new risk categories so far underestimated.
KW - Antifungal prophylaxis
KW - Infectious Diseases
KW - Microbiology
KW - Microbiology (medical)
KW - Virology
KW - drug-drug interactions
KW - echinocandins
KW - mold-active agents
KW - polyenes
KW - Antifungal prophylaxis
KW - Infectious Diseases
KW - Microbiology
KW - Microbiology (medical)
KW - Virology
KW - drug-drug interactions
KW - echinocandins
KW - mold-active agents
KW - polyenes
UR - https://publicatt.unicatt.it/handle/10807/125228
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85050533446&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85050533446&origin=inward
U2 - 10.1080/14787210.2018.1496329
DO - 10.1080/14787210.2018.1496329
M3 - Article
SN - 1478-7210
VL - 16
SP - 531
EP - 542
JO - Expert Review of Anti-Infective Therapy
JF - Expert Review of Anti-Infective Therapy
IS - 7
ER -