Vnitr Lek 2008, 54(12):1187-1194

Guidelines for the treatment of invasive aspergillosis

Z. Ráčil1,*, J. Mayer1, I. Kocmanová2, J. Haber3, N. Mallátová4, M. Kouba5, P. Sedláček6, E. Faber7, I. Herold8, P. Múdry9, L. Drgoňa10, M. Karas11, V. Buchta12, J. Vydra13, M. Kolář14, J. Trupl15, V. Marešová16, H. Rozsypal16, O. Nýč17, K. Cwiertka18
1 Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, zastupující přednosta prof. MUDr. Jiří Mayer, CSc.
2 Oddělení klinické mikrobiologie FN Brno, prim. MUDr. Alena Ševčíková
3 I. interní klinika - hematoonkologická 1. lékařské fakulty UK a VFN Praha, přednosta doc. MUDr. Marek Trněný, CSc.
4 Laboratoř lékařské parazitologie a mykologie, Centrální laboratoře, Nemocnice České Budějovice a.s., České Budějovice, ředitel MUDr. Miroslav Verner
5 Ústav hematologie a krevní transfuze Praha, ředitel prof. Ing. Jan E. Dyr, DrSc.
6 Klinika dětské hematologie a onkologie 2. lékařské fakulty UK a FN Motol Praha, přednosta prof. MUDr. Jan Starý, DrSc.
7 Hematoonkologická klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Karel Indrák, DrSc.
8 Anesteziologicko-resuscitační oddělení Klaudiánovy nemocnice Mladá Boleslav, přednosta prim. MUDr. Ivan Herold, CSc.
9 Klinika dětské onkologie Lékařské fakulty MU a FN Brno, pracoviště FDN JGM, přednosta prof. MUDr. Jaroslav Štěrba, Ph.D.
10 Národný onkologický ústav Bratislava, Slovenská republika, riaditeľ prof. MUDr. Ivan Koza, CSc.
11 Hematologicko-onkologické oddělení FN Plzeň, přednosta prim. MUDr. Vladimír Koza
12 Ústav klinické mikrobiologie Lékařské fakulty UK a FN Hradec Králové, přednosta doc. MUDr. Vladimír Buchta, CSc.
13 Oddělení klinické hematologie FN Královské Vinohrady Praha, přednosta doc. MUDr. Tomáš Kozák, Ph.D.
14 Klinika anesteziologie a resuscitace 1. lékařské fakulty UK a VFN Praha, přednosta doc. MUDr. Jan Stříteský, CSc.
15 Klinika laboratorní medicíny SYNLAB s r.o., Bratislava, Slovenská republika, prednosta prof. RNDr. Jan Trupl, Ph.D.
16 I. infekční klinika 2. lékařské fakulty UK a FN Na Bulovce Praha, přednostka doc. MUDr. Vilma Marešová, CSc.
17 Ústav lékařské mikrobiologie 2. lékařské fakulty UK a FN Motol Praha, přednosta doc. MUDr. Otakar Nýč, Ph.D.
18 Onkologická klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Bohuslav Melichar, Ph.D.

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

Keywords: invasive aspergillosis; treatment; guidelines; antimycotics

Received: August 12, 2008; Published: December 1, 2008  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. Vnitr Lek. 2008;54(12):1187-1194.
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    References

    1. Ráčil Z, Mayer J (eds). Invazivní aspergilóza: současné možnosti diagnostiky. Vnitř Lék 2007; 53 (Suppl): S1-S34.
    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: 49-59. Go to original source...
    3. Walsh TJ, Anaissie EJ, Denning DW et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2008; 46: 327-360. Go to original source... Go to PubMed...
    4. Ascioglu S, Rex JH, 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: 7-14. Go to original source... Go to PubMed...
    5. Herbrecht R, Denning DW, Patterson TF et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347: 408-415. Go to original source... Go to PubMed...
    6. Chen SC, Sorrell TC. Antifungal agents. Med J Aust 2007; 187: 404-409. Go to original source... Go to PubMed...
    7. Ostrosky-Zeichner L, Marr KA, Rex JH et al. Amphotericin B: time for a new "gold standard". Clin Infect Dis 2003; 37: 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: 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 OA, 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: 1289-1297. Go to original source... Go to PubMed...
    11. Chandrasekar PH, Ito JI. Amphotericin B lipid complex in the management of invasive aspergillosis in immunocompromised patients. Clin Infect Dis 2005; 40 (Suppl 6): S392-S400. Go to original source... Go to PubMed...
    12. Bowden R, Chandrasekar P, White MH 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: 359-366. Go to original source... Go to PubMed...
    13. Denning DW, Lee JY, Hostetler JS et al. NIAID Mycoses Study Group Multicenter Trial of Oral Itraconazole Therapy for Invasive Aspergillosis. Am J Med 1994; 97: 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: e83-e90. Go to original source... Go to PubMed...
    15. Prentice AG, Glasmacher A. Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother 2005; 56 (Suppl 1): 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 DW, Marr KA, Lau WM et al. Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis. J Infect 2006; 53: 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: 372-379. Go to original source... Go to PubMed...
    19. Mukherjee PK, Sheehan DJ, Hitchcock CA et al. Combination treatment of invasive fungal infections. Clin Microbiol Rev 2005; 18: 163-194. Go to original source... Go to PubMed...
    20. Kontoyiannis DP, Hachem R, Lewis RE 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: 292-299. Go to original source... Go to PubMed...
    21. Singh N, Limaye AP, 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: 320-326. Go to original source... Go to PubMed...
    22. Patterson TF, Boucher HW, 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: 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: 205-209. Go to original source... Go to PubMed...
    24. Oppenheim BA, Herbrecht R, Kusne S. The safety and efficacy of amphotericin B colloidal dispersion in the treatment of invasive mycoses. Clin Infect Dis 1995; 21: 1145-1153. Go to original source... Go to PubMed...
    25. Denning DW, Ribaud P, Milpied N et al. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin Infect Dis 2002; 34: 563-571. Go to original source... Go to PubMed...
    26. Perfect JR, Marr KA, Walsh TJ et al. Voriconazole treatment for less-common, emerging, or refractory fungal infections. Clin Infect Dis 2003; 36: 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: 227-233. Go to original source... Go to PubMed...
    28. Walsh TJ, Raad I, Patterson TF 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: 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: 1563-1571. Go to original source... Go to PubMed...
    30. Kartsonis NA, Saah AJ, Joy Lipka C et al. Salvage therapy with caspofungin for invasive aspergillosis: results from the caspofungin compassionate use study. Journal of Infection 2005; 50: 196-205. Go to original source... Go to PubMed...
    31. Aliff TB, Maslak PG, Jurcic JG et al. Refractory Aspergillus pneumonia in patients with acute leukemia: successful therapy with combination caspofungin and liposomal amphotericin. Cancer 2003; 97: 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: 2888-2897. Go to original source... Go to PubMed...
    33. Marr KA, Boeckh M, Carter RA et al. Combination antifungal therapy for invasive aspergillosis. Clin Infect Dis 2004; 39: 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 JP, Ramamurthy L, Denning DW et al. An algorithmic approach to aspergillus sinusitis. J Laryngol Otol 1994; 108: 314-318. Go to original source... Go to PubMed...
    36. Patterson TF, Kirkpatrick WR, White M et al. Invasive aspergillosis. Disease spectrum, treatment practices, and outcomes. I3 Aspergillus Study Group. Medicine (Baltimore) 2000; 79: 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: 2641-2645. Go to original source... Go to PubMed...
    38. Subira M, Martino R, Franquet T et al. Invasive pulmonary aspergillosis in patients with hematologic malignancies: survival and prognostic factors. Haematologica 2002; 87: 528-534. Go to PubMed...
    39. Dignani MC, Anaissie EJ, Hester JP et al. Treatment of neutropenia-related fungal infections with granulocyte colony-stimulating factor-elicited white blood cell transfusions: a pilot study. Leukemia 1997; 11: 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: 955-963. Go to original source... Go to PubMed...
    41. Bernard A, Caillot D, Couaillier JF et al. Surgical management of invasive pulmonary aspergillosis in neutropenic patients. Ann Thorac Surg 1997; 64: 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: 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: 500-505. Go to original source... Go to PubMed...
    44. Steinbach WJ, Benjamin DK Jr, Kontoyiannis DP et al. Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases. Clin Infect Dis 2004; 39: 192-198. Go to original source... Go to PubMed...
    45. Denning DW, Radford SA, Oakley KL et al. Correlation between in-vitro susceptibility testing to itraconazole and in-vivo outcome of Aspergillus fumigatus infection. J Antimicrob Chemother 1997; 40: 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: 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: 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: 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: 443-451. Go to original source... Go to PubMed...
    50. Pasqualotto AC, Shah M, Wynn R et al. Voriconazole plasma monitoring. Arch Dis Child 2008: 93: 578-581. Go to original source... Go to PubMed...
    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: 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: 1532-1535. Go to original source... Go to PubMed...
    53. Dodds Ashley E, Lewis R, Lewis J et al. Pharmacology of Systemic Antifungal Agents. 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. Clin Microbiol Infect 2007; 12: 84-90. Go to original source...
    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: 137-143. Go to original source... Go to PubMed...
    56. Leenders AC, Daenen S, Jansen RL 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: 205-212. Go to original source... Go to PubMed...

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