Anest. intenziv. Med. 2009;20(1):48-56

Guidelines for the treatment of invasive aspergillosisGuidelines

Ráčil Zdenek1,*, Mayer Jiří1, Kocmanová Iva2, Haber Jan3, Mallátová Naďa4, Kouba Michal5, Sedláček Petr6, Faber Edgar7, Herold Ivan8, Múdry Peter9, Drgoňa Luboš10, Karas Michal11, Buchta Vladimír12, Vydra Jan13, Kolář Michal14, Trupl Jan15, Marešová Vilma16, Rozsypal Hanuš16, Nyč Otakar17, Cwiertka Karel18
1 Interní hematoonkologická klinika, FN Brno
2 Oddělení klinické mikrobiologie, FN Brno
3 I. interní klinika - hematoonkologická VFN, Praha
4 Laboratoř lékařské parazitologie a mykologie, Centrální laboratoře, Nemocnice České Budějovice, a. s.
5 Ústav hematologie a krevní transfuze Praha
6 Klinika dětské hematologie a onkologie FN Motol, Praha
7 Hematoonkologická klinika FN Olomouc
8 ARO, Klaudiánova nemocnice Mladá Boleslav
9 Klinika dětské onkologie, FN Brno
10 Národný onkologický ústav, Bratislava, Slovensko
11 Hematologicko-onkologické oddělení FN Plzeň
12 Ústav klinické mikrobiologie FN Hradec Králové
13 Oddělení klinické hematologie FNKV Praha
14 KAR VFN, Praha
15 Klinika laboratorní medicíny SYNLAB, s. r. o., Bratislava, Slovensko
16 Infekční klinika FN Na Bulovce, Praha
17 Ústav lékařské mikrobiologie FN Motol, Praha
18 Onkologická klinika FN Olomouc

An increasing incidence of invasive aspergillosis is observed in most immunocompromised patients, and especially in patients with acute leukemia and following haematopoietic stem cell transplantation. In order to decrease mortality due to this infection, clinicians need to optimize their treatment choices.
The objective of these guidelines is to summarize the current evidence for the treatment of invasive aspergillosis. The recommendations have been developed by an expert panel following an evidence-based literature search with regard to current recommendations of the European Conference in Infections in Leukemia and Infectious Diseases Society of America.

Keywords: invasive aspergillosis; treatment guidelines; antimycotics

Published: February 1, 2009  Show citation

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Ráčil Z, Mayer J, Kocmanová I, Haber J, Mallátová N, Kouba M, et al.. Guidelines for the treatment of invasive aspergillosis. Anest. intenziv. Med. 2009;20(1):48-56.
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    References

    1. Ráčil, Z., Mayer, J. (eds) Invazivní aspergilóza: současné možnosti diagnostiky. Vnitř. Lék., 2007, 53, Suppl.
    2. Herbrecht, R., Fluckiger, U., Gachot, B. et al. Treatment of invasive Candida and invasive Aspergillus infections in adult haematological patients. European Journal of Cancer Supplements. Guidelines from the First European Conference on Infections in Leukaemia: ECIL1, 2007, 5, p. 49-59. Go to original source...
    3. Walsh, T. J., Anaissie, E. J., Denning, D. W. et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin. Infect. Dis., 2008, 46, p. 327-360. Go to original source... Go to PubMed...
    4. Ascioglu, S., Rex, J. H., de Pauw, B. et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin. Infect. Dis., 2002, 34, p. 7-14. Go to original source... Go to PubMed...
    5. Herbrecht, R., Denning, D. W., Patterson, T. F. et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N. Engl. J. Med., 2002, 347, p. 408-415. Go to original source... Go to PubMed...
    6. Chen, S. C., Sorrell, T. C. Antifungal agents. Med. J. Aust., 2007, 187, p. 404-409. Go to original source... Go to PubMed...
    7. Ostrosky-Zeichner, L., Marr, K. A., Rex, J. H. et al. Amphotericin B: time for a new "gold standard". Clin. Infect. Dis., 2003, 37, p. 415-425. Go to original source... Go to PubMed...
    8. Ellis, M., Spence, D., de Pauw, B. et al. An EORTC international multicenter randomized trial (EORTC number 19923) comparing two dosages of liposomal amphotericin B for treatment of invasive aspergillosis. Clin. Infect. Dis., 1998, 27, p. 1406-1412. Go to original source... Go to PubMed...
    9. Cordonnier, C., Bresnik, M., Ebrahimi, R. Liposomal Amphotericin B (L-AMB) Efficacy in Invasive Filamentous Fungal Infections (IFI): Pooled Analysis. Program and abstracts of the 44th ICAAC October 30 - November 2, 2004, Abstract M-1022.
    10. Cornely, O. A., Maertens, J., Bresnik, M. et al. Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin. Infect. Dis., 2007, 44, p. 1289-1297. Go to original source... Go to PubMed...
    11. Chandrasekar, P. H., Ito, J. I. Amphotericin B lipid complex in the management of invasive aspergillosis in immunocompromised patients. Clin. Infect. Dis., 2005, 40, Suppl 6, p. S392-400. Go to original source... Go to PubMed...
    12. Bowden, R., Chandrasekar, P., White, M. H. et al. A double-blind, randomized, controlled trial of amphotericin B colloidal dispersion versus amphotericin B for treatment of invasive aspergillosis in immunocompromised patients. Clin. Infect. Dis., 2002, 35, p. 359-366. Go to original source... Go to PubMed...
    13. Denning, D. W., Lee, J. Y., Hostetler, J. S. et al. NIAID Mycoses Study Group Multicenter Trial of Oral Itraconazole Therapy for Invasive Aspergillosis. Am. J. Med., 1994, 97, p. 135-144. Go to original source... Go to PubMed...
    14. Caillot, D., Bassaris, H., McGeer, A. et al. Intravenous itraconazole followed by oral itraconazole in the treatment of invasive pulmonary aspergillosis in patients with hematologic malignancies, chronic granulomatous disease, or AIDS. Clin. Infect. Dis., 2001, 33, p. e83-90. Go to original source... Go to PubMed...
    15. Prentice, A. G., Glasmacher, A. Making sense of itraconazole pharmacokinetics. J. Antimicrob. Chemother., 2005, 56, Suppl 1, p. i17-i22. Go to original source... Go to PubMed...
    16. Viscoli, C., Herbrecht, R., Akan, H. Caspofungin (C) as first-line therapy of invasive aspergillosis (IA) in haematological patients (pts): a study of the EORTC Infectious Diseases Group. 3th Trends in Medical Mycology 2007: Abstract O.12.
    17. Denning, D. W., Marr, K. A., Lau, W. M. et al. Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis. J. Infect., 2006, 53, p. 337-349. Go to original source... Go to PubMed...
    18. Kohno, S., Masaoka, T., Yamaguchi, H. et al. A multicenter, open-label clinical study of micafungin (FK463) in the treatment of deep-seated mycosis in Japan. Scand. J. Infect. Dis., 2004, 36, p. 372-379. Go to original source... Go to PubMed...
    19. Mukherjee, P. K., Sheehan, D. J., Hitchcock, C. A. et al. Combination treatment of invasive fungal infections. Clin. Microbiol. Rev., 2005, 18, p. 163-194. Go to original source... Go to PubMed...
    20. Kontoyiannis, D. P., Hachem, R., Lewis, R. E. et al. Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies. Cancer, 2003, 98, p. 292-299. Go to original source... Go to PubMed...
    21. Singh, N., Limaye, A. P., Forrest, G. et al. Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. Transplantation, 2006, 81, p. 320-326. Go to original source... Go to PubMed...
    22. Patterson, T. F., Boucher, H. W., Herbrecht, R. et al. Strategy of following voriconazole versus amphotericin B therapy with other licensed antifungal therapy for primary treatment of invasive aspergillosis: impact of other therapies on outcome. Clin. Infect. Dis., 2005, 41, p. 1448-1452. Go to original source... Go to PubMed...
    23. Cordonnier, C., Bresnik, M., Ebrahimi, R. Liposomal amphotericin B (AmBisome) efficacy in confirmed invasive aspergillosis and other filamentous fungal infections in immunocompromised hosts: a pooled analysis. Mycoses, 2007, 50, p. 205-209. Go to original source... Go to PubMed...
    24. Oppenheim, B. A., Herbrecht, R., Kusne, S. The safety and efficacy of amphotericin B colloidal dispersion in the treatment of invasive mycoses. Clin. Infect. Dis., 1995, 21, p. 1145-1153. Go to original source... Go to PubMed...
    25. Denning, D. W., Ribaud, P., Milpied, N. et al. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin. Infect. Dis., 2002, 34, p. 563-571. Go to original source... Go to PubMed...
    26. Perfect, J. R., Marr, K. A., Walsh, T. J. et al. Voriconazole treatment for less-common, emerging, or refractory fungal infections. Clin. Infect. Dis., 2003, 36, p. 1122-1131. Go to original source... Go to PubMed...
    27. Candoni, A., Mestroni, R., Damiani, D. et al. Caspofungin as first line therapy of pulmonary invasive fungal infections in 32 immunocompromised patients with hematologic malignancies. Eur. J. Haematol., 2005, 75, p. 227-233. Go to original source... Go to PubMed...
    28. Walsh, T. J., Raad, I., Patterson, T. F. et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin. Infect. Dis., 2007, 44, p. 2-12. Go to original source... Go to PubMed...
    29. Maertens, J., Raad, I., Petrikkos, G. et al. Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy. Clin. Infect. Dis., 2004, 39, p. 1563-1571. Go to original source... Go to PubMed...
    30. Kartsonis, N. A., Saah, A. J., Joy Lipka, C. et al. Salvage therapy with caspofungin for invasive aspergillosis: results from the caspofungin compassionate use study. Journal of Infection, 2005, 50, p. 196-205. Go to original source... Go to PubMed...
    31. Aliff, T. B., Maslak, P. G., Jurcic, J. G. et al. Refractory Aspergillus pneumonia in patients with acute leukemia: successful therapy with combination caspofungin and liposomal amphotericin. Cancer, 2003, 97, p. 1025-1032. Go to original source... Go to PubMed...
    32. Maertens, J., Glasmacher, A., Herbrecht, R. et al. Multicenter, noncomparative study of caspofungin in combination with other antifungals as salvage therapy in adults with invasive aspergillosis. Cancer, 2006, 107, p. 2888-2897. Go to original source... Go to PubMed...
    33. Marr, K. A., Boeckh, M., Carter, R. A. et al. Combination antifungal therapy for invasive aspergillosis. Clin. Infect. Dis., 2004, 39, p. 797-802. Go to original source... Go to PubMed...
    34. Raad, I., Hachem, R., Jiang, H. Combination Salvage Therapy of Invasive Aspergillosis (IA) in Patients with Hematologic Malignancy (HM): Which Caspofungin-Containing Regimen? Program and abstracts of the 44th ICAAC 2007: M-624.
    35. de Carpentier, J. P., Ramamurthy, L., Denning, D. W. et al. An algorithmic approach to aspergillus sinusitis. J. Laryngol. Otol., 1994, 108, p. 314-318. Go to original source... Go to PubMed...
    36. Patterson, T. F., Kirkpatrick, W. R., White, M. et al. Invasive aspergillosis. Disease spectrum, treatment practices, and outcomes. I3 Aspergillus Study Group. Medicine (Baltimore), 2000, 79, p. 250-260. Go to original source... Go to PubMed...
    37. Schwartz, S., Ruhnke, M., Ribaud, P. et al. Improved outcome in central nervous system aspergillosis, using voriconazole treatment. Blood, 2005, 106, p. 2641-2645. Go to original source... Go to PubMed...
    38. Sunita, M., Martino, R., Franquet, T. et al. Invasive pulmonary aspergillosis in patients with hematologic malignancies: survival and prognostic factors. Haematologica, 2002, 87, p. 528-534. Go to PubMed...
    39. Dignani, M. C., Anaissie, E. J., Hester, J. P. et al. Treatment of neutropenia-related fungal infections with granulocyte colony-stimulating factor-elicited white blood cell transfusions: a pilot study. Leukemia, 1997, 11, p. 1621-1630. Go to original source... Go to PubMed...
    40. Cordonnier, C., Ribaud, P., Herbrecht, R. et al. Prognostic factors for death due to invasive aspergillosis after hematopoietic stem cell transplantation: a 1-year retrospective study of consecutive patients at French transplantation centers. Clin. Infect. Dis., 2006, 42, p. 955-963. Go to original source... Go to PubMed...
    41. Bernard, A., Caillot, D., Couaillier, J. F. et al. Surgical management of invasive pulmonary aspergillosis in neutropenic patients. Ann. Thorac. Surg., 1997, 64, p. 1441-1447. Go to original source... Go to PubMed...
    42. Gossot, D., Validire, P., Vaillancourt, R. et al. Full thoracoscopic approach for surgical management of invasive pulmonary aspergillosis. Ann. Thorac. Surg., 2002, 73, p. 240-244. Go to original source... Go to PubMed...
    43. Pagano, L., Ricci, P., Nosari, A. et al. Fatal haemoptysis in pulmonary filamentous mycosis: an underevaluated cause of death in patients with acute leukaemia in haematological complete remission. A retrospective study and review of the literature. Gimema Infection Program (Gruppo Italiano Malattie Ematologiche dell'Adulto). Br. J. Haematol., 1995, 89, p. 500-505. Go to original source... Go to PubMed...
    44. Steinbach, W. J., Benjamin, D. K. Jr., Kontoyiannis, D. P. et al. Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases. Clin. Infect. Dis., 2004, 39, p. 192-198. Go to original source... Go to PubMed...
    45. Denning, D. W., Radford, S. A., Oakley, K. L. et al. Correlation between in-vitro susceptibility testing to itraconazole and in-vivo outcome of Aspergillus fumigatus infection. J. Antimicrob. Chemother., 1997, 40, p. 401-414. Go to original source... Go to PubMed...
    46. Lass-Florl, C., Kofler, G., Kropshofer, G. et al. In-vitro testing of susceptibility to amphotericin B is a reliable predictor of clinical outcome in invasive aspergillosis. J. Antimicrob. Chemother., 1998, 42, p. 497-502. Go to original source... Go to PubMed...
    47. Smith, J., Safdar, N., Knasinski, V. et al. Voriconazole therapeutic drug monitoring. Antimicrob. Agents. Chemother., 2006, 50, p. 1570-1572. Go to original source... Go to PubMed...
    48. Theuretzbacher, U., Ihle, F., Derendorf, H. Pharmacokinetic/pharmacodynamic profile of voriconazole. Clin. Pharmacokinet., 2006, 45, p. 649-663. Go to original source... Go to PubMed...
    49. Glasmacher, A., Hahn, C., Leutner, C. et al. Breakthrough invasive fungal infections in neutropenic patients after prophylaxis with itraconazole. Mycoses, 1999, 42, p. 443-451. Go to original source... Go to PubMed...
    50. Pasqualotto, A. C., Shah, M., Wynn, R. et al. Voriconazole plasma monitoring. Arch. Dis. Child., 2008. Go to original source...
    51. Pascual, A., Calandra, T., Bolay, S. et al. Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. Clin. Infect. Dis., 2008, 46, p. 201-211. Go to original source... Go to PubMed...
    52. Trifilio, S., Pennick, G., Pi, J. et al. Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer, 2007, 109, p. 1532-1535. Go to original source... Go to PubMed...
    53. Dodds Ashley, E., Lewis, R., Lewis, J. et al. Pharmacology of Systemic Antifungal Agents; doi:10.1086/504492. Clinical Infectious Diseases 2006; 43: S28-S39. Go to original source...
    54. Glasmacher, A., Prentice, A. Current experience with itraconazole in neutropenic patients: a concise overview of pharmacological properties and use in prophylactic and empirical antifungal therapy. Clinical Microbiology & Infection, 12, p. 84-90. Go to PubMed...
    55. Pascual, A., Nieth, V., Calandra, T. et al. Variability of voriconazole plasma levels measured by new high-performance liquid chromatography and bioassay methods. Antimicrob. Agents. Chemother., 2007, 51, p. 137-143. Go to original source... Go to PubMed...
    56. Leenders, A. C., Daenen, S., Jansen, R. L. et al. Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia-associated invasive fungal infections. Br. J. Haematol., 1998, 103, p. 205-212. Go to original source... Go to PubMed...

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