AMPHOTERICIN-B PROPHYLAXIS AGAINST INVASIVE FUNGAL-INFECTIONS IN NEUTROPENIC PATIENTS - A SINGLE-CENTER EXPERIENCE FROM 1980 TO 1995

Fungal infections are a common complication in hematological and oncol ogical patients, In the study the results of a retrospective analysis of the onset of fungal infections among 383 patients admitted at the h ematology unit of San Camillo Hospital, Rome, from 1980 to 1995 are re ported, In the eleven Sears prior to 1991 only four cases of fungal in fection were detected in high risk patients (1.8 % of the high risk pa tients), From 1991 to 1993 there was a dramatic increase of fungal inf ections (Candida and Aspergillus), Thirteen cases of infections were o bserved during this period, eight of which were due to Aspergillus (12 % of the high risk patients), For this reason it was decided to intro duce a different prophylactic treatment for all high risk patients con sisting of combined conventional intravenous (i.v.) amphotericin B, or al amphotericin B and nebulized amphotericin B, starting from the firs t day of hospitalization. Since the introduction of this new prophylac tic regimen no cases of invasive fungal infections were observed in th e 48 high risk patients examined, The prophylactic treatment was well tolerated by all patients, The results suggest that the combined use o f oral, nebulized and i.v. amphotericin B is very effective in prevent ing invasive fungal infections in high risk patients.