Empirical, Pre-emptive and Prophylactic Therapy of Invasive Mycoses: Current State of the Problem

Clinical Microbiology and Antimicrobial Chemotherapy. 2009; 11(4):286-304

Type
Journal article

Abstract

Invasive mycoses in patients with severe diseases – ICU patients, patients with hematological malignancies and after solid organ transplantations represent a significant target for the use of prophylactic, empirical and pre-emptive antifungal therapy. This is not only because of high incidence of invasive mycoses among this population but also because of high mortality levels and diseaserelated costs. There is no doubt that as early as possible diagnosis provides the most favorable prognosis in this group of patients. Currently there is substantial number of antifungal drugs for systemic use that allows us to make an adequate choice of therapy in particular patient according to clinical scenario, the presence of certain risk factors, epidemiological data regarding potential etiological agents and overall clinical pharmacology of antifungal agents. In the current article the information regarding prophylactic, pre-emptive and empirical therapy of invasive mycoses in different categories of patients will be presented. Also some aspects of diagnostic approaches on invasive fungal infections will be discussed.

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