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JAC Advance Access published online on January 16, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh085
© 2004 by The British Society for Antimicrobial Chemotherapy
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© 2004 The British Society for Antimicrobial Chemotherapy

Leading article

Preventative use of antifungal drugs in patients treated for cancer

Ben de Pauw 1 *

1 Blood Transfusion Service and Department of Haematology, University Medical Centre St Radboud, Geert Grooteplein Zuid 6, 6525 GA Nijmegen, The Netherlands

* Corresponding author. E-mail: B.dePauw{at}HEMAT.umcn.nl.

Abstract

Prophylactic use of antifungal compounds has more or less become standard clinical practice for patients who are treated for a haematological malignancy. However, apart from the prevention of infections by Candida species in bone marrow transplant recipients and a possible reduction in invasive aspergillosis in high-risk patients, there is little evidence to justify this approach. Antifungals ought to be administered to patients on their perceived individual risk and better studies should be conducted to provide a more rational basis for our clinical decisions. Results of studies in specific populations should not be used to create guidelines for other patient groups or general populations. Antifungals are potentially toxic and overuse might be associated with unnecessary direct and indirect drug-related costs.

Keywords: prophylaxis, neutropenia, fungal infection, antifungals
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