Prophylaxis and Aspergillosis — Has the Principle Been Proven?

Abstract

Invasive fungal diseases contribute substantially to death and illness associated with the prolonged, profound neutropenia resulting from intensive chemotherapy for hematologic cancers and from myeloablation for allogeneic hematopoietic stem-cell transplantation. In addition, the development of graft-versus-host disease (GVHD) puts transplant recipients at risk for infection for several weeks or months after engraftment.¹ Given the high mortality associated with invasive fungal diseases and our inability to recognize active cases reliably, it is not surprising that prophylaxis is perceived as a sensible therapeutic approach.More than a decade ago, fluconazole was shown to be effective for preventing candida infection.² However, aspergillus species . . .