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Titolo:
Breakthrough invasive fungal infections in neutropenic patients after prophylaxis with itraconazole
Autore:
Glasmacher, A; Hahn, C; Leutner, C; Molitor, E; Wardelmann, E; Losem, C; Sauerbruch, T; Marklein, G; Schmidt-Wolf, IGH;
Indirizzi:
Univ Bonn, Dept Internal Med, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 n, Dept Internal Med, D-5300 Bonn, Germany Univ Bonn, Dept Radiol, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 iv Bonn, Dept Radiol, D-5300 Bonn, Germany Univ Bonn, Inst Med Microbiol & Immunol, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 Microbiol & Immunol, D-5300 Bonn, Germany Univ Bonn, Inst Pathol, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 iv Bonn, Inst Pathol, D-5300 Bonn, Germany
Titolo Testata:
MYCOSES
fascicolo: 7-8, volume: 42, anno: 1999,
pagine: 443 - 451
SICI:
0933-7407(199909/10)42:7-8<443:BIFIIN>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
MULTIPLE-DOSE PHARMACOKINETICS; PULMONARY ASPERGILLOSIS; ANTIFUNGAL PROPHYLAXIS; AMPHOTERICIN-B; HEMATOLOGICAL MALIGNANCIES; SYSTEMIC MYCOSES; ORAL SOLUTION; IN-VITRO; CHEMOTHERAPY; PREVENTION;
Keywords:
fungal infections; antifungal prophylaxis; itraconazole; epidemiology; breakthrough infections;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Glasmacher, A Univ Bonn, Dept Internal Med, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 al Med, D-5300 Bonn, Germany
Citazione:
A. Glasmacher et al., "Breakthrough invasive fungal infections in neutropenic patients after prophylaxis with itraconazole", MYCOSES, 42(7-8), 1999, pp. 443-451

Abstract

This study analyses invasive fungal infections in neutropenic patients with haematological malignancies during antifungal prophylaxis with itraconazole. From September 1994 to December 1998 20 patients developed fungal infections. Two patients suffered from disseminated infections by yeasts and 18 patients suffered from pulmonary infections by moulds (eight proven, 10 highly probable in high-resolution CT scans). In these patients the itraconazole trough concentrations exceeded 500 ng ml(-1) (measured by high performance liquid chromatography) significantly less often (median 48%, interquartile range 0-100%) than in another group of 150 leukaemia patients without invasive fungal infections who received 287 courses of prophylaxis with itraconazole at our institution (median 100%, interquartile range 38-100%, P=0.039). Twelve patients died, six of these had refractory disease. Patients with fatal invasive fungal infections had lower median itraconazole concentrations immediately before occurrence of the infection than patients with non-fatal infections: 120 (0-478) ng ml(-1) versus 690 (305-1908) ng ml(-1) (P=0.039). In conclusion, this analysis of breakthrough invasive fungal infections during prophylaxis with itraconazole demonstrates that patients with itraconazole trough concentrations below 500 ng ml(-1) were significantly more likely to develop fungal infections and that the last itraconazole trough concentration before occurrence of the infection was significantly lowerin patients with fatal invasive fungal infections.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 01:47:00