Reducing Empirical Antifungal Therapy with a Biomarker-Based Diagnostic Strategy

In a randomized study of high-risk patients, weekly or semiweekly polymerase chain reaction and galactomannan testing reduced the use of empirical antifungal therapy without affecting mortality.

Neutropenic patients suspected of having invasive fungal infections often receive empirical antifungal therapy because of delays in diagnosis by culture and histology. Polymerase chain reaction (PCR) and an enzyme-linked assay for aspergillosis galactomannan produce results much sooner, potentially reducing the use of empirical antifungal treatment.

To examine this possibility, researchers conducted a randomized, controlled, open-label, parallel-group study among adults undergoing allogeneic stem-cell transplantation or intensive combination chemotherapy for acute leukemia at any of six centers in Australia. Within 48 hours after starting conditioning therapy or chemotherapy, the 240 participants were randomized to either the standard diagno…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)