泊沙康唑
医学
伏立康唑
血液学
曲菌病
内科学
指南
临床试验
随机对照试验
重症监护医学
抗真菌
免疫学
病理
皮肤病科
作者
Julien Coussement,Julian Lindsay,Benjamin W Teh,Monica Slavin
出处
期刊:Current Opinion in Infectious Diseases
[Ovid Technologies (Wolters Kluwer)]
日期:2021-05-25
卷期号:34 (4): 297-306
被引量:9
标识
DOI:10.1097/qco.0000000000000737
摘要
This review aims to summarize available guidelines as well as the emerging evidence for the prevention and treatment of invasive fungal diseases in high-risk haematology patients.Primary mould-active prophylaxis is the strategy used in many centres to manage the risk of invasive fungal disease in high-risk haematology patients, and posaconazole remains the antifungal of choice for most of these patients. Data on the use of other antifungals for primary prophylaxis, including isavuconazole, are limited. There is considerable interest in identifying a strategy that would limit the use of mould-active agents to the patients who are the most likely to benefit from them. In this regard, a recent trial demonstrated that the preemptive strategy is noninferior to the empiric strategy. For primary treatment of invasive aspergillosis, two randomized trials found isavuconazole and posaconazole to be noninferior to voriconazole. Isavuconazole does not appear to require therapeutic drug monitoring.Prophylaxis and treatment of invasive fungal diseases in high-risk haematology patients is a rapidly evolving field. Critical clinical questions remain unanswered, especially regarding the management of suspected invasive fungal diseases breaking through mould-active prophylaxis, and the duration of antifungal therapy for invasive mould infections.
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