Surveillance invasiver Fadenpilzmykosen in lungentransplantierten Patienten: Effekt antimykotischer Prophylaxe mit Itraconazol und Voriconazol. Surveillance of invasive mold infections in lung transplant recipients: effect of antimycotic prophylaxis with itraconazole and voriconazole
| Autor: | B. Haubitz, Lutz Mattner, Frauke Mattner, H Weissbrodt, Jens Gottlieb, Stefan Fischer, Petra Gastmeier, Iris F. Chaberny, Martin Strueber |
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| Rok vydání: | 2005 |
| Předmět: |
Voriconazole
medicine.medical_specialty Lung Itraconazole business.industry Incidence (epidemiology) medicine.medical_treatment Dermatology General Medicine Perioperative medicine.disease Aspergillosis Surgery Infectious Diseases medicine.anatomical_structure Internal medicine medicine Lung transplantation Zygomycosis business medicine.drug |
| Zdroj: | Mycoses. 48:51-55 |
| ISSN: | 1439-0507 0933-7407 |
| Popis: | Between January 2002 and December 2003 all 157 patients (pts) that underwent lung transplantation (LTx) at our institution were prospectively screened for invasive aspergillosis (IA) during their perioperative hospital stay. Patients were regarded as IA positive, if they met the EORTC criteria for 'probable' or 'proven' IA. Records of pts were screened retrospectively for antimycotic prophylaxis. Eight of the 157 pts developed 'probable' or 'proven' IA (5.1%) within 17 +/- 10 days after LTx. This was associated with a 14-fold increased mortality compared with all pts without aspergillosis (P POD 14). By switching our prophylactic strategy to the use of voriconazole in high risk pts, we have decreased the incidence of IA from 8% (six of 75) in 2002 to 2% (two of 82) in 2003. This study shows a high incidence of IA during the very early postoperative course after LTx of 5%. This is associated with a significantly increased risk for mortality. Voriconazole prophylaxis appears to be superior to itraconazole, especially in high risk pts with pretransplant Aspergillus colonization. |
| Databáze: | OpenAIRE |
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