Antifungal strategies for managing invasive aspergillosis: The prospects for a pre-emptive treatment strategy

Abstract

Invasive Aspergillosis (IA) is now the leading infectious cause of mortality in patients with haematological malignancies. Studies have identified those patient groups and the time-periods associated with high-risk for IA. The current management strategies for IA include prophylaxis and empiric antifungal therapy (EAFT). The rationale for prophylaxis in high-risk patients exists. However toxicities, drug interactions and breakthrough infections limit the benefits and the optimal duration for prophylaxis remains unknown. In recent EAFT studies in high-risk patients, <10% of persistent febrile neutropenic episodes were due to IA, suggesting that a disproportionate number of patients are treate..