Oral antifungals as prophylaxis in haematological malignancy

Blood Reviews
A G Prentice, P Donnelly

Abstract

In the standard treatment of patients with haematological malignancy, immunosuppressive therapy produces prolonged periods of neutropenia and mucositis, which increase the risk of systemic fungal infection. In allogeneic bone marrow transplantation, this risk extends well beyond the period of neutropenia when graft-versus-host disease, and its treatment, result in prolonged lymphocytopenia. Various agents are used for antifungal prophylaxis and treatment but all have limitations: amphotericin B is restricted by the need for intravenous infusion and the occurrence of adverse events, fluconazole by its narrow spectrum of activity and the emergence of fluconazole-resistant fungi and itraconazole capsules by erratic absorption. Oral administration of antifungals has clear advantages in prophylaxis and an important current strategy is to maximize the extent and reliability of the oral bioavailability of antifungal agents. Mucositis is the main obstacle for success of strategies based on oral delivery. In this review, the ability of these new oral formulations to deliver sufficient antifungal prophylaxis is evaluated.

References

Oct 1, 1979·Annals of Internal Medicine·J R WingardR Saral
Jan 1, 1992·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·F PersatM A Piens
Mar 1, 1990·Reviews of Infectious Diseases·H A GallisW W Pickard
Sep 1, 1986·Antimicrobial Agents and Chemotherapy·T E Rogers, J N Galgiani
Oct 1, 1986·European Journal of Clinical Microbiology·R J StockleyR R Slade
Jan 1, 1983·Clinical Pharmacokinetics·T K Daneshmend, D W Warnock
Aug 1, 1984·Oral Surgery, Oral Medicine, and Oral Pathology·A P Barrett
Jan 1, 1995·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J R Wingard
Aug 1, 1994·The Journal of Antimicrobial Chemotherapy·A G PrenticeD A Oliver
Aug 1, 1994·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J R Wingard
Aug 1, 1994·The Journal of Infectious Diseases·E J AnaissieV Paetznick
Jun 1, 1994·Annals of Internal Medicine·F MenichettiUNKNOWN GIMEMA Infection Program
Sep 1, 1993·Antimicrobial Agents and Chemotherapy·C A HitchcockD W Warnock
Oct 1, 1993·Clinical Pharmacokinetics·M Schäfer-Korting
Sep 1, 1995·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M JandrlićV Bogdanić
Aug 1, 1996·Chest·N C Klein, B A Cunha
Feb 1, 1997·Cleveland Clinic Journal of Medicine·Y P Lee, M Goldman
Jun 17, 1998·European Journal of Clinical Pharmacology·S Jaruratanasirikul, S Sriwiriyajan
Aug 26, 1998·Therapeutic Drug Monitoring·A J McLachlan, S E Tett
Jul 30, 1999·Journal of the American Academy of Dermatology·A K GuptaN H Shear

❮ Previous
Next ❯

Citations

Oct 17, 2006·Clinical Microbiology Reviews·Joseph MeletiadisThomas J Walsh
Mar 17, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Patricia MuñozManuel Desco
Apr 26, 2002·British Journal of Haematology·Nicole M A BlijlevensBen E de Pauw
Jun 28, 2008·Dynamic Medicine : DM·Gregory R Waryasz, Ann Y McDermott
Dec 25, 2012·International Ophthalmology·Kiyofumi MochizukiHideaki Kawakami
Dec 16, 2010·Expert Review of Pharmacoeconomics & Outcomes Research·Daoud Al-BadriyehDavid C M Kong

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Central Nervous System Fungal Infections

Central nervous system fungal infections are rare and typically occur in immunocompromised patients, such as those with HIV infection or transplant recipients. Discover the latest research on central nervous system fungal infections here.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.