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Annals of Oncology 5:571-574, 1994
© 1994 European Society for Medical Oncology

review-article

Chemoprophylaxis of fungal infections in neutropenic patients

M. Björkholm

Department of Internal Medicine, Section of Hematology and Medical Immunology, Karolinska Hospital Stockholm, Sweden

Correspondence to: Magnus Bjorkholm, M.D., Ph.D.,Department of Internal Medicine, Section of Hematology and Medical Immunology, Karolinska Hospital, S-17176 Stockholm, Sweden

BACKGROUND:: In recent years there has been an increasing incidence and awareness of mucosal candidiasis and invasive fungal infections in neutropenic patients. Early diagnosis (before serious morbidity and mortality) is often difficult, emphasizing the continuing need for adequate prophylaxis.

DESIGN:: A review of studies on the chemoprophylaxis of fungal infections in neutropenic patients.

RESULTS:: There is a limited number of large, prospective, well-designed studies using proper criteria and end points. No antifungal drug or drug combination has been shown to prevent invasive fungal infection with the exception of fluco-nazole (mainly Candida Albicans infections) in certain high-risk patient groups.

CONCLUSIONS:: Prophylaxis strategies are dependent upon local conditions, patient populations, types of therapies, available resources, etc. Future improvement will be based upon a) improved study quality, b) new strategies for established drugs, c) development of new and safer drugs, d) new strategies to eliminate or reduce immunosuppression and e) cost-benefit studies.

disseminated candidiasis, invasive aspergillosis neutropenia, prophylaxis


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