Choice and duration of antifungal prophylaxis and treatment in high-risk haematology patients

Coussement, J; Lindsay, J; Teh, BW; Slavin, M

Author(s): Coussement, J; Lindsay, J; Teh, BW; Slavin, M;
Details: Publication Year 2021-08,Volume 34,Issue #4,Page 297-306
Journal Title: Current Opinion in Infectious Diseases
Publication Type: Review
Abstract: PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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. SUMMARY: 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.
Keywords: Antifungal Agents/therapeutic use; *Aspergillosis/drug therapy; *Hematology; Humans; *Invasive Fungal Infections/drug therapy/prevention & control; Voriconazole
Department(s): Infectious Diseases
PubMed ID: 34039878
Publisher's Version: https://doi.org/10.1097/QCO.0000000000000737
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-09-05 01:45:05

Last Modified: 2025-09-05 01:46:46