Universität zu Köln

Maertens, Johan A., Girmenia, Corrado, Bruggemann, Roger J., Duarte, Rafael F., Kibbler, Christopher C., Ljungman, Per, Racil, Zdenek, Ribaud, Patricia, Slavin, Monica A., Cornely, Oliver A., Donnelly, J. Peter and Cordonnier, Catherine (2018). European guidelines for primary antifungal prophylaxis in adult haematology patients: summary of the updated recommendations from the European Conference on Infections in Leukaemia. J. Antimicrob. Chemother., 73 (12). S. 3221 - 3231. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

The European Conference on Infections in Leukaemia (ECIL) updated its guidelines on antifungal prophylaxis for adults using the grading system of IDSA. The guidelines were extended to provide recommendations for other haematological diseases besides AML and recipients of an allogeneic haematopoietic stem cell transplantation (HSCT). Posaconazole remains the drug of choice when the incidence of invasive mould diseases exceeds 8%. For patients undergoing remission-induction chemotherapy for AML and myelodysplastic syndrome (MDS), fluconazole can still offer an alternative provided it forms part of an integrated care strategy that includes screening with biomarkers and imaging. Similarly, aerosolized liposomal amphotericin B combined with fluconazole can be considered for patients at high risk of invasive mould diseases but other formulations of the polyene are discouraged. Fluconazole is still recommended as primary prophylaxis for patients at low risk of invasive mould diseases during the pre-engraftment phase of allogeneic HSCT whereas only a moderate recommendation could be made for itraconazole, posaconazole and voriconazole for patients at high risk. Posaconazole is strongly recommended for preventing invasive mould disease post-engraftment but only when graft-versus-host disease (GvHD) was accompanied by other risk factors such as its severity, use of an alternative donor or when unresponsive to standard corticosteroid therapy. The need for primary prophylaxis for other patient groups was less clear and should be defined by the estimated risk of invasive fungal disease (IFD).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maertens, Johan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Girmenia, Corrado UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruggemann, Roger J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duarte, Rafael F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kibbler, Christopher C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ljungman, Per UNSPECIFIED UNSPECIFIED UNSPECIFIED Racil, Zdenek UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribaud, Patricia UNSPECIFIED UNSPECIFIED UNSPECIFIED Slavin, Monica A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Donnelly, J. Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Cordonnier, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-163923
DOI:	10.1093/jac/dky286
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	73
Number:	12
Page Range:	S. 3221 - 3231
Date:	2018
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE FUNGAL-INFECTIONS; CELL TRANSPLANT RECIPIENTS; ITRACONAZOLE ORAL SOLUTION; TRIAL COMPARING ITRACONAZOLE; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; FLUCONAZOLE PROPHYLAXIS; RISK-FACTORS; PHASE 1B; ASPERGILLOSIS Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16392