粒细胞缺乏发热患者的真菌治疗策略.pptVIP

En raison de l’importance du critère survie pour cette pathologie et ce type de patients et compte tenu de la limite de significativité obtenue avec l’analyse en ITM, une analyse complémentaire de type Kaplan Meier a été réalisée pour le même sous-critère ?? Survie à 7 jours de traitement??. Et cette fois-ci, l’analyse de Kaplan Meier permet d’observer une survie à 7 jours statistiquement prolongée (p=0.044) des patients traités par CANCIDAS par rapport aux patients traités par l’ampho B liposomale. This slide illustrates 4 possible approaches to antifungal therapy, according to degree of risk and/or certainty of diagnosis In patients at highest risk for invasive fungal infection—allogeneic HSCT recipients, for example—antifungal prophylaxis against Candida infection is standard1 Empirical therapy may be warranted in high-risk patients who have persistent fever despite broad-spectrum antibacterial therapy, because systemic fungal infection is one possible explanation of the signs of infection1,2 Initiation of presumptive therapy is recommended as soon as a systemic fungal infection is suspected, at the same time that a diagnostic workup is under way to confirm and further characterize the infection3,4 Specific treatment may be initiated once an infection is confirmed and possibly further characterized1,5 Although knowledge of the infecting species, or even susceptibility testing of an individual isolate, may guide antifungal therapy, host factors are often the more critical determinant of the clinical response to antifungal therapy2 References 1. Pappas PG, Rex JH, Sobel JD, et al. Guidelines for treatment of candidiasis. Clin Infect Dis. 2004;38:161-189. 2. Hayes-Lattin B, Maziarz RT. Update in the epidemiology, prophylaxis, and treatment of fungal infections in patients with hematologic disorders. Leuk Lymphoma. 2004;45:669-680. 3. Stevens DA, Kan VL, Judson MA, et al. Practice guidelines for diseases caused by Aspergillus. Clin Infect Dis. 2000;3