Treatment of invasive aspergillosis in cancer patients
Invasive fungal infections (IFI) remain a leading cause of morbidity and mortality in immunocompromised patients. Despite major improvements, it often remains difficult to obtain accurate diagnosis in neutropenic patients. Timely initiation of antifungal treatment in this high-risk population is mandatory to improve survival. Today, clinicians have a choice among a growing armamentarium of novel antifungal agents. Agents such as "veteran" amphotericin B deoxycholate (d-AMB) have been replaced with lipid formulations, and new generation triazoles as well as novel class echinocandins finally offer opportunities to improve prognosis with less systemic toxicity. Clinical decision-making depends on several guidelines, published studies and not least on economic considerations. The current review summarises up-to-date treatment recommendations of the DGHO/AGIHO, and ECIL-3, as well as the recently published 2010 Clinical Practice Guidelines of the IDSA.