How to safely discontinue antifungal treatment in invasive pulmonary aspergillosis? - Clinical considerations in haematology - PubMed
2 days ago
- #invasive pulmonary aspergillosis
- #hematological malignancies
- #antifungal stewardship
- Treatment duration for invasive pulmonary aspergillosis (IPA) in hematological malignancy patients lacks clear clinical trial definitions, often relying on experience.
- Discontinuation of antifungal therapy requires individualized assessment of immune status, clinical stability, mycological markers (e.g., serum galactomannan), and imaging findings.
- Standardized criteria for treatment failure, stable disease, and stopping therapy are lacking, necessitating bundled interpretation of multiple factors.
- Prerequisites for stopping treatment include structured surveillance, triggers for re-evaluation, and scenarios where therapy must continue.
- Risks of recurrence in immunocompromised patients must be balanced against prolonged antifungal toxicity and drug interactions.
- Prospective trials are needed to optimize treatment duration, especially during ongoing immunosuppression.