Empiric therapy with amphotericin B in febrile granulocytopenic patients

T. J. Walsh*, J. Lee, J. Lecciones, M. Rubin, K. Butler, P. Francis, M. Weinberger, E. Roilides, D. Marshall, J. Gress, P. A. Pizzo

*Corresponding author for this work

Research output: Contribution to journalShort surveypeer-review

Abstract

The early diagnosis of invasive fungal infection in granulocytopenic patients remains unreliable. Granulocytopenic patients who are persistently or recurrently febrile despite therapy with appropriate antibacterial agents are at high risk for the development of such infection. Two randomized clinical trials demonstrated that the empiric administration of amphotericin B to persistently or recurrently febrile granulocytopenic patients decreased the frequency, morbidity, and mortality of invasive fungal infection; these effects were especially marked in profoundly granulocytopenic patients who were not receiving antifungal prophylaxis. Current studies continue to indicate that prompt empiric administration of amphotericin B to persistently or recurrently febrile granulocytopenic patients ensures earlier treatment of deep mycoses. The roles of newer antifungal triazole compounds and of liposomal and lipid complexes of amphotericin B in empiric antifungal therapy must be investigated further in thoughtfully designed, randomized clinical trials.

Original languageEnglish
Pages (from-to)496-503
Number of pages8
JournalReviews of Infectious Diseases
Volume13
Issue number3
DOIs
StatePublished - 1991
Externally publishedYes

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