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
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.