scholarly journals Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations

2018 ◽  
Vol 4 (3) ◽  
pp. 94 ◽  
Author(s):  
Nikolaos V. Sipsas ◽  
Maria N. Pagoni ◽  
Diamantis P. Kofteridis ◽  
Joseph Meletiadis ◽  
Georgia Vrioni ◽  
...  
Keyword(s):  
Financial Crisis ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Patient Characteristics ◽  
Invasive Fungal Infections ◽  
Therapeutic Drug ◽  
Treatment Practices ◽  
Timely Fashion ◽  
Greek Hospitals ◽  
Construction Works

There are concerns that the financial crisis in Greece negatively affected the management of invasive fungal infections (IFIs) among patients with hematological malignancies (HM). A working group (WG) was formed to explore the situation and make recommendations. A questionnaire was created and distributed to physicians caring for patients with HM, to gather information in a standardized manner on prescribing physicians, patient characteristics, availability of diagnostics, antifungal treatment practices and the conditions and particularities of Greek hospitals. A total of 141 physicians from 36 hematology units and laboratories located in 26 Greek hospitals participated. Regarding hospitalization conditions, only 56% reported that their patients were treated in isolated single or double bed rooms, 22% reported availability of HEPA filters, 47% reported construction works in progress, and an alarming 18% reported the presence of birds on open windows. Regarding diagnosis, only 31% reported availability of biomarkers for diagnosis of IFIs, 76% reported that CT scans were performed in a timely fashion, 42% reported prompt availability of broncho-alveolar lavage, and only 6% availability of therapeutic drug monitoring. Of concern, 26% of the responders reported non-availability of some antifungals. In conclusion, significant challenges exist for the optimal management of IFIs in patients with HM in Greece.

scholarly journals (1, 3)-β-D-glucan assay for diagnosing invasive fungal infections in critically ill patients with hematological malignancies

Oncotarget ◽  
2016 ◽  
Vol 7 (16) ◽  
pp. 21484-21495 ◽  
Author(s):  
Elie Azoulay ◽  
Nicolas Guigue ◽  
Michael Darmon ◽  
Djamel Mokart ◽  
Virginie Lemiale ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Invasive Fungal Infections

Therapeutic Drug Monitoring of Voriconazole in the Management of Invasive Fungal Infections: A Critical Review

2015 ◽  
Vol 54 (12) ◽  
pp. 1223-1235 ◽  
Author(s):  
Hazem Elewa ◽  
Eman El-Mekaty ◽  
Ahmed El-Bardissy ◽  
Mary H. H. Ensom ◽  
Kyle John Wilby
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Critical Review ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Therapeutic Drug

scholarly journals Prophylaxis of Invasive Fungal Infections: A Review of the Use of Posaconazole

2009 ◽  
Vol 1 ◽  
pp. CMT.S1948
Author(s):  
Curtis D. Collins ◽  
Jeannina A. Smith ◽  
Daniel R. Kaul
Keyword(s):  
At Risk ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Invasive Fungal Infections ◽  
Cost Of Care ◽  
Therapeutic Drug ◽  
Patients At Risk

Invasive fungal infections (IFIs) cause significant morbidity, mortality, and increased cost of care in patients with hematological malignancies, prolonged (i.e. >7-10 days) treatment induced neutropenia, and other disease states causing underlying immunosuppression. One strategy often used to combat the development of invasive infections is the use of antifungal agents as prophylaxis in at risk patients. Posaconazole is an oral triazole with a useful spectrum of activity against many fungal pathogens of concern in patients at risk for the development of IFIs. Posaconazole is only available in oral formulation and therapeutic drug monitoring may provide value due to variable absorption and serum concentrations. Clinical efficacy and pharmacoeconomic data have demonstrated the utility of posaconazole in the treatment of oropharyngeal candidiasis and for prophylaxis in patients at risk for development of IFIs. Several organizations or expert groups involved in developing guidelines for the management of IFIs recommend posaconazole anti-fungal prophylaxis in patients with AML or MDS and chemotherapy induced neutropenia or significant GVHD. In addition, nonrandomized studies (largely of salvage therapy) and case series suggest that posaconazole may be effective as treatment for invasive aspergillosis, zygomycosis, and coccidiomycosis. Further, small case series or individual case reports suggest activity against other less commonly encountered filamentous fungi and Histoplasma.

scholarly journals Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

2002 ◽  
Vol 15 (3) ◽  
pp. 465-484 ◽  
Author(s):  
Siew Fah Yeo ◽  
Brian Wong
Keyword(s):  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Diagnostic Methods ◽  
Current Status ◽  
Course Of Disease ◽  
Host Immune Responses ◽  
Appropriate Treatment ◽  
Recent Developments ◽  
Timely Fashion ◽  
Fungal Antigens

SUMMARY The incidence of invasive fungal infections has increased dramatically in recent decades, especially among immunocompromised patients. However, the diagnosis of these infections in a timely fashion is often very difficult. Conventional microbiologic and histopathologic approaches generally are neither sensitive nor specific, and they often do not detect invasive fungal infection until late in the course of disease. Since early diagnosis may guide appropriate treatment and prevent mortality, there has been considerable interest in developing nonculture approaches to diagnosing fungal infections. These approaches include detection of specific host immune responses to fungal antigens, detection of specific macromolecular antigens using immunologic reagents, amplification and detection of specific fungal nucleic acid sequences, and detection and quantitation of specific fungal metabolite products. This work reviews the current status and recent developments as well as problems in the design of nonculture diagnostic methods for invasive fungal infections.

Significant alterations in the epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies

2008 ◽  
Vol 88 (5) ◽  
pp. 508-515 ◽  
Author(s):  
Jutta Auberger ◽  
Cornelia Lass-Flörl ◽  
Hanno Ulmer ◽  
Elisabeth Nogler-Semenitz ◽  
Johannes Clausen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Invasive Fungal Infections

Risk stratification for invasive fungal infections in patients with hematological malignancies: SEIFEM recommendations

Blood Reviews ◽  
2017 ◽  
Vol 31 (2) ◽  
pp. 17-29 ◽  
Author(s):  
Livio Pagano ◽  
Alessandro Busca ◽  
Anna Candoni ◽  
Chiara Cattaneo ◽  
Simone Cesaro ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Invasive Fungal Infections
Sign in / Sign up

Export Citation Format

Share Document