Intravenous itraconazole: Use in allogenic bone marrow transplantation and acute leukaemias

The management of systemic fungal infections can be divided into four main strategies: prophylaxis, early empirical use, pre-emptive therapy and target therapy. This article addresses the use of itraconazole for fungal infections in patients with haematological malignancies or receiving bone marrow transplantation (BMT). Itraconazole is now available in both oral and intravenous formulations, with a broad spectrum of activity including Aspergillus, and Candida albicans and non-albicans species. Plenty of controlled clinical trials have confirmed that prophylaxis with itraconazole is effective in reducing rates of systemic fungal infections. In empirical use, large randomized studies have supported the efficacy of itraconazole, while in the targeted therapy itraconazole can be used alone or in combination with other antifungal drugs such as caspofungin. Itraconazole, when appropriately used, is a cost/effective choice for the management of fungal infections. © 2007 Pharma Project Group srl.