Current treatment options for invasive aspergillosis

Abstract

Invasive pulmonary aspergillosis is a major cause of morbidity and mortality in immunocompromised patients, particularly those with hematological malignancies in the setting of profound neutropenia and/or hematopoietic stem cell transplant recipients. The optimal therapy for invasive aspergillosis relies on the restoration of leukocyte counts and effective antifungal treatment initiated at the earliest stage of infection. Several alternative antifungal compounds are currently available. A rational approach should take into account not only the degree of certainty of infection (as codified by the EORTC/MSG classification), but also previous exposure to other antifungals, the pharmacokinetic and pharmacodynamic characteristics of the antifungals employed and the clinical characteristics of the patient.

Keywords: Amphotericin B; Antifungal drugs; Antifungal therapy; Azoles; Caspofungin; Echinocandins; Immunocompromised hosts; Invasive aspergillosis; Invasive fungal infection; Polyene antibiotics; Voriconazole.