Incidence of Invasive Fungal Infection (IFI) Represents Nearly 20% of the patient's leucemic infections and mortality can reach 40-60% 1 . P is used as antifungal prophylaxis for high-risked patients thesis During severe and prolonged neutropenia.
We Evaluated the antifungal prophylaxis P Notifying the incidence of proven / probable IFIs.
We Realized a retrospective study of P treatment in 2007 in hemato-oncology year adult unit. The data file Managed Were thanks to a postponement sheet Containing Several items on patients, treatments and evolution.Classification of fungal infections Was based on the consensus criteria of the EORTC 2 .
We included 22 patients (64% men, 46% women) of Whom 86% Suffer from acute myelogenous leukemia (AML). The median age 51. Was P Was prescribed in IFI prophylaxis During prolonged neutropenia and severe post-chemotherapy (72%) or post autologous transplant (28%), Initiated 7 days before neutropenia in 50% of cases. The mean treatment period Was 18 days. Colonization occured in one third of patients (43% of C. albicans ) . Esomeprazole (E) 40mg Was associated in 64% of cases.
Antifungal prophylaxis failed 3 in 50% of cases and an empirical treatment with caspofungin Was Proposed.Different failure's causes Were: proven IFIs to Geotrichum capitatum (n = 1) Suspected IFIs (n = 5) Witch 2 are possible, and not swallowing (n = 5). No aspergillosis occured. Were patient's hospitalization prolonged but no death Was reported.
P prophylaxis Seems To be efficient thesis Among high risk patients in prophylaxy aspergillosis, there is purpose appearance of an uncommon fungus. Late initiation, E or P resorption interaction Difficulties Could be significant in therapeutic success. It Would be interesting to optimize P treatment with plasmatic dosages.
Full conference title:
- RICAI 28th (2008)