Abstract:
:Antifungal prophylaxis can be recommended in patients undergoing induction chemotherapy for acute myeloid leukemia and treatment for grade 2 or greater or chronic extensive graft versus host disease. The evidence for prophylaxis is less clear in other clinical settings although certain groups such as patients with prolonged neutropenia after stem cell transplants using bone marrow or cord blood sources and with impaired cell mediated immunity secondary to treatments such as Alemtuzumab are at high risk. The decision to use prophylaxis and which agent to use will be influenced by effectiveness, number needed to treat and the likelihood of toxicity and drug interactions. The availability of rapid diagnostic tests for fungal infection and institutional epidemiology will also influence the need for and choice of prophylaxis. Whilst prophylaxis can be beneficial, it may impede the ability to make a rapid diagnosis of fungal infection by reducing the yield of diagnostic tests and change the epidemiology of fungal infection. As non-culture based diagnostic tests are refined and become more available there may be a shift from prophylaxis to early diagnosis and treatment.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Slavin MA,Heath CH,Thursky KA,Morrissey CO,Szer J,Ling LM,Milliken ST,Grigg APdoi
10.1111/j.1445-5994.2008.01723.xsubject
Has Abstractpub_date
2008-06-01 00:00:00pages
468-76issue
6beissn
1444-0903issn
1445-5994pii
IMJ1723journal_volume
38pub_type
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