[Azole antifungal agents in the prevention of fungal infections in neutropenic patients and bone marrow graft recipients].

Fungal infections are often encountered in neutropenic patients and bone marrow graft recipients. Several studies have demonstrated the efficacy of antifungal prophylaxis. Regimens including azole compounds are increasingly used due to facilitate administration. The efficacy of fluconazole to prevent systemic candidiasis was recently documented in multicentric studies in bone marrow recipients but is more controversial in neutropenic patients. The risk of selecting strains of Candida with lower sensitivity to azole compounds must also be taken into consideration. There has not been any large study evidencing a primary prophylactic affect of itraconazole against invasive aspergillosis, but the results of multicentric studies should be available soon. Recent trials have attempted to determine how these compounds can best be used in empirical treatment of persistent fever in neutropenic patients and in secondary prophylaxis for mycoses during later intensive treatment protocols.