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[Decrease in systemic fungal infections in hematological neoplasms with empirical use of amphotericin B therapy].

M B Zimmermann-Hölsi1, R A Stahel, P Vogt

  • 1Medizinishe Klinik, Universitätsspital Zürich.

Schweizerische Medizinische Wochenschrift
|January 14, 1989
PubMed
Summary

Empiric antifungal treatment with amphotericin B significantly reduced systemic fungal infections in hematologic malignancy patients. This approach lowered infection rates from 10% to 4%, particularly benefiting acute myelogenous leukemia patients.

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Area of Science:

  • Infectious Diseases
  • Hematology
  • Mycology

Background:

  • Systemic fungal infections pose a significant risk in patients with hematological malignancies, with high autopsy incidence and diagnostic challenges.
  • Empiric antifungal therapy is often necessary due to difficulties in early diagnosis of systemic mycosis.

Purpose of the Study:

  • To evaluate the impact of a routine empiric antifungal treatment protocol on the incidence of systemic fungal infections in patients with hematological malignancies.

Main Methods:

  • Implementation of a routine empiric antifungal treatment regimen in 1982.
  • Administration of amphotericin B and flucytosine to granulocytopenic patients presenting with specific clinical signs suggestive of fungal infection (fever, pulmonary infiltrates, sinusitis, etc.).

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Main Results:

  • A significant decrease in the rate of systemic fungal infections from 10% to 4% (p < 0.02).
  • The most pronounced reduction was observed in patients with acute myelogenous leukemia, where fungal infections dropped from 16% to 4% (p < 0.025).

Conclusions:

  • Empiric antifungal treatment with amphotericin B is effective in reducing systemic fungal infections in patients with hematological malignancies.
  • The protocol demonstrated particular efficacy in acute myelogenous leukemia patients, highlighting the benefit of early intervention.