Fleming, S., Yannakou, C.K., Haeusler, G.M., Clark, J., Grigg, A., Heath, C.H., . . . Slavin, M.A. (2014). Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2014. Internal Medicine Journal, 44, 1283–1297. 

DOI Link

Purpose & Patient Population

PURPOSE: To assist clinicians in providing optimal preventive care to patients with hematologic malignancies and those undergoing hematopoietic cell transplantation (HCT)
 
TYPES OF PATIENTS ADDRESSED: Adult and pediatric patients with cancer at highest risk for fungal infections

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Consensus-based guideline

PROCESS OF DEVELOPMENT: Not fully described. Provides only search terms used

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care
 
APPLICATIONS: Pediatrics

Results Provided in the Reference

Not stated

Guidelines & Recommendations

  • Identifies high-risk factors as low neutrophil counts; unrelated or mismatched HCT; a combination of systemic steroid use and low neutrophil counts; high-dose cytarabine, fludarabine, or alemtuzumab; and those with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML)
  • Recommends prophylaxis for patients undergoing allogeneic HCT until at least day 75 or for 16 weeks in patients with graft-versus-host disease
  • Recommends mold active prophylaxis for high-risk patients
  • Recommends anticandida prophylaxis for low-risk patients
  • Provides a review of individual prophylactic medications and application with specific antitumor agents used
  • Recommends secondary prophylaxis in those with previous invasive fungal disease

Limitations

No quality grading of evidence

Nursing Implications

Provides information regarding risk factors for consideration in determining the specific type of prophylactic agent to be used, and provides comprehensive information regarding metabolism, etc., of individual antifungals.